扩大诊疗范围与减少儿科心理健康护理中的种族差异有关。

IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Community Mental Health Journal Pub Date : 2024-11-01 Epub Date: 2024-07-01 DOI:10.1007/s10597-024-01310-6
Phillip M Hughes, Genevive Graaf, Kristin H Gigli, Neal A deJong, Robert E McGrath, Kathleen C Thomas
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引用次数: 0

摘要

目的:研究执业范围(SoP)规定与儿科心理健康服务中的种族差异之间的关联。我们利用《全国儿童健康调查》(2016-2020 年;n = 33790)来研究心理学家和执业护士(NP)的执业范围扩大和未扩大的州之间在未满足的心理健康护理需求和接受心理健康药物治疗方面的种族差异。我们的主要结果是:(1)未得到满足的心理保健需求;(2)接受心理保健药物治疗的情况。我们使用逻辑回归法(SoP 扩展与种族/族裔之间的交互项)检验了 SoP 扩展对结果的异质性治疗效果。我们估算了这两项结果在人群层面的种族差异,并根据 SoP 扩展情况进行分层,以确定种族差异的不同。其他种族儿童的未满足需求减少了 15.8 个百分点 (CI= -25.3, -6.2),高于白人儿童。心理学家 SoP 扩大后,黑人儿童的用药量增加了 5.1 个百分点(CI=0.8, 9.4),其他种族儿童的用药量增加了 5.6 个百分点(CI=0.5, 10.8)。在 NP SoP 扩大方面没有发现差异。在心理学家 SoP 扩大的州,这两项结果的种族差异都较小,但在 NP SoP 州则有所不同。总体而言,扩大 SoP 与降低儿科心理保健获得方面的种族差异有关。
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Scope-of-Practice Expansions Associated with Reduced Racial Disparities in Pediatric Mental Health Care.

To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children's Health (2016-2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication. We examined heterogeneous treatment effects of SoP expansion on the outcomes using logistic regression with interaction terms between SoP expansion and race/ethnicity. We estimated population-level racial disparities for both outcomes stratified by SoP expansion to identify differences in racial disparities. The psychologist SoP expansion-associated reduction in unmet need was 15.8 percentage-points (CI= -25.3, -6.2) larger for Other-race children than for White children. The psychologist SoP expansion-associated increase in medication was 5.1%-points (CI=. 0.8, 9.4) larger for Black children and 5.6%-points (CI = 0.5, 10.8) for Other-race children. No differences were found for NP SoP expansion. Racial disparities in both outcomes were lower in psychologist SoP expansion states but varied in NP SoP states. Expanded SoP was generally associated with lower racial disparities in pediatric mental health care access.

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来源期刊
CiteScore
5.30
自引率
3.70%
发文量
133
期刊介绍: Community Mental Health Journal focuses on the needs of people experiencing serious forms of psychological distress, as well as the structures established to address those needs. Areas of particular interest include critical examination of current paradigms of diagnosis and treatment, socio-structural determinants of mental health, social hierarchies within the public mental health systems, and the intersection of public mental health programs and social/racial justice and health equity. While this is the journal of the American Association for Community Psychiatry, we welcome manuscripts reflecting research from a range of disciplines on recovery-oriented services, public health policy, clinical delivery systems, advocacy, and emerging and innovative practices.
期刊最新文献
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