Racial-ethnic composition of provider practices and disparities in treatment of depression and anxiety, 2003-2007. Other Scholarly Work

Lagomasino, Isabel T, Stockdale, Susan E, Miranda, Jeanne. (2011). Racial-ethnic composition of provider practices and disparities in treatment of depression and anxiety, 2003-2007. . PSYCHIATRIC SERVICES, 62(9), 1019-1025. 10.1176/appi.ps.62.9.1019

cited authors

  • Lagomasino, Isabel T; Stockdale, Susan E; Miranda, Jeanne

authors

abstract

  • Objectives

    This study explored whether racial and ethnic disparities in the treatment of depression and anxiety are associated with provider-level factors.

    Methods

    This study analyzed 58,826 office-based adult outpatient visits to primary care physicians and psychiatrists. Data were from the National Ambulatory Medical Care Survey, 2003-2007. Outcomes included counseling and referral for counseling, antidepressant prescription, and any care for depression or anxiety. The analyses of treatment outcomes were not limited to visits with a depression or anxiety diagnosis.

    Results

    Compared with visits to primary care physicians by whites, such visits by blacks and Hispanics were less likely to result in antidepressant prescription or in any care for depression or anxiety; primary care visits by Hispanics were also less likely to result in counseling. Compared with visits to psychiatrists by whites, such visits by blacks were less likely to result in an antidepressant prescription. The majority of visits to both primary care physicians and psychiatrists by blacks and Hispanics were to practices serving a high percentage of nonwhite patients. However, racial and ethnic disparities in care that were especially evident in primary care settings persisted after the analyses controlled for whether visits were to settings with a high or low percentage of nonwhite patients.

    Conclusions

    Disparities in care for depression and anxiety in primary care continue and are not fully accounted for by less care being provided in settings that nonwhites frequent. Physician bias, resource issues, and patient factors may all play a role in the diagnosis and treatment of depression and anxiety.

publication date

  • September 1, 2011

published in

keywords

  • Anxiety
  • Depression
  • Female
  • Health Care Surveys
  • Health Personnel
  • Healthcare Disparities
  • Humans
  • Male
  • Primary Health Care
  • Racial Groups
  • United States

Digital Object Identifier (DOI)

Medium

  • Print

start page

  • 1019

end page

  • 1025

volume

  • 62

issue

  • 9