Tuesday, April 1, 2014

African Americans Less Likely to Receive Follow-Up Care After Psychiatric Admission, Study Finds

Poor integration of follow-up treatment into the continuum of psychiatric care leaves many individuals, particularly blacks, with poor-quality treatment, according to a report, "Quality of Follow-Up After Hospitalization for Mental Illness Among Patients From Racial-Ethnic Minority Groups," published online today in Psychiatric Services in Advance.

Researchers at the Center for Multicultural Mental Health Research, Cambridge Health Alliance, and Department of Psychiatry at Harvard Medical School used the Medical Expenditure Panel Survey (2004–2010) to identify adults with any inpatient psychiatric treatment (N=339). They then estimated predictors of outpatient follow-up or the beginning of adequate outpatient follow-up within seven or 30 days following discharge. Predicted disparities were calculated after adjustment for clinical-need variables but not for socioeconomic characteristics, consistent with the Institute of Medicine definition of health care disparities as differences that are unrelated to clinical appropriateness, need, or patient preference.

Rates of follow-up were generally low, particularly rates of adequate treatment, which were on average less than 26%. Outpatient treatment prior to inpatient care was a strong predictor of follow-up. After adjustment for need and socioeconomic status, the analyses showed that blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge.

“Culturally appropriate interventions that link individuals in inpatient settings to outpatient follow-up are needed to reduce racial-ethnic disparities in outpatient mental health treatment following acute treatment,” the researchers stated.

For more information on health disparities in mental illness and its treatment, see the Psychiatric News article, "Overcoming Health Disparities is Goal of Baltimore Experiment."

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