Objective: To compare patterns of health care utilization associated with first presentation of psychosis among different racial and ethnic groups of patients.
Design: The study was a retrospective observational design.
Setting: The study was conducted in five health care systems in the western United States. All sites were also part of the National Institute of Mental Health-funded Mental Health Research Network (MHRN).
Participants: Patients (n = 852) were aged 15 - 59 years (average 26.9 ± 12.2 years), 45% women, and primarily non-Hispanic White (53%), with 16% Hispanic, 10% non-Hispanic Black, 6% Asian, 1% Native Hawaiian/Pacific Islander, 1% Native American/ Alaskan Native, and 12% unknown race/ethnicity.
Main outcome measures: Variables examined were patterns of health care utilization, type of comorbid mental health condition, and type of treatment received in the three years before first presentation of psychosis.
Methods: Data abstracted from electronic medical records and insurance claims data were organized into a research virtual data warehouse (VDW) and used for analysis.
Results: Compared with non-Hispanic Whites, Asian patients (16% vs 34%; P=.007) and non-Hispanic Black patients (20% vs 34%; P=.009) were less likely to have a visit with specialty mental health care before their first presentation of psychosis.
Conclusions: Early detection of first episode psychosis should start with wider screening for symptoms outside of any indicators for mental health conditions for non-Hispanic Black and Asian patients.
Keywords: First Episode Psychosis; Mental Health Research Network; Virtual Data Warehouse.
Copyright © 2019, Ethnicity & Disease, Inc.
Conflict of interest statement
Competing Interests: None declared.
Race-ethnicity and Gender Differences in VA Health Care Service Utilization Among U.S. Veterans of Recent ConflictsKH Koo et al. Psychiatr Serv 66 (5), 507-13. PMID 25588415.Although service utilization rates between minority groups and whites were similar when minority groups were combined, examination of utilization by racial-ethnic groups …
The Role of Race and Ethnicity in the State Children's Health Insurance Program (SCHIP) in Four States: Are There Baseline Disparities, and What Do They Mean for SCHIP?LP Shone et al. Pediatrics 112 (6 Pt 2), e521. PMID 14654674.SCHIP is enrolling substantial numbers of racial and ethnic minority children. There are baseline racial and ethnic disparities among new enrollees in SCHIP, with black a …
Racial and Ethnic Disparities in Diabetes Screening Between Asian Americans and Other Adults: BRFSS 2012-2014EL Tung et al. J Gen Intern Med 32 (4), 423-429. PMID 27848187.Despite their high risk of diabetes, Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening.
Mortality Disparities in Racial/Ethnic Minority Groups in the Veterans Health Administration: An Evidence Review and MapK Peterson et al. Am J Public Health 108 (3), e1-e11. PMID 29412713. - ReviewAlthough the VHA's equal access health care system has reduced many racial/ethnic mortality disparities present in the private sector, our review identified mortality dis …
Screening and Interventions for Childhood Overweight [Internet]EP Whitlock et al. PMID 20722132. - ReviewBMI measurement to detect overweight in older adolescents could identify those at increased risk of developing adult obesity, and its consequent morbidities. Promising in …