Retrospective Cohort Study of Racial-Ethnic Disparities in Receipt of Electroconvulsive Therapy, 2016-2021.

IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES
Steven Sprenger, Gerardo Corsi, Alexandre Koumtchev, Natalie Hurlock
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引用次数: 0

Abstract

Objective: Electroconvulsive therapy (ECT) is an effective treatment for severe depression, but racial-ethnic disparities in its receipt have long been observed, and previous studies have had limited generalizability. This study aimed to determine whether racial-ethnic disparities persist in contemporary treatment environments after adjustment for various demographic factors.

Methods: A retrospective study was conducted among patients with data in the HCA Healthcare Enterprise Data Warehouse who were diagnosed as having severe unipolar depression (ICD-10 codes F32-F33) and who sought care in any of 162 inpatient and outpatient facilities between 2016 and 2021. Patients were grouped by self-reported racial-ethnic identity. The association between race-ethnicity and selected covariates was determined by using chi-square tests (α=0.05), and the relationship between race-ethnicity and ECT receipt, given selected predictor variables, was estimated by using logistic regression.

Results: Analyses were conducted for 19,011 unique patients. Significant variation by race-ethnicity was found for all covariates (p<0.001). ECT was administered to 3% of White patients and 1% of non-White patients. Compared with all other race-ethnicities, the unadjusted odds ratio for ECT receipt among White patients was 3.12 (p<0.001). Patients from each non-White racial-ethnic group had significantly lower rates of ECT receipt compared with White patients, including Asian (adjusted OR [aOR]=0.43, p<0.001), Black (aOR=0.27, p<0.001), and Hispanic (aOR=0.39, p<0.001) patients and patients identifying as other race-ethnicity (aOR=0.53, p=0.001).

Conclusions: In this nationwide study, significant disparities in ECT use, by self-identified racial-ethnic identity, were observed even after demographic covariates were controlled.

2016-2021年接受电休克治疗的种族差异回顾性队列研究
目的:电痉挛疗法(ECT)是治疗重度抑郁症的有效方法,但长期以来观察到其接受的种族差异,以往的研究具有有限的普遍性。本研究旨在确定在调整各种人口因素后,种族-民族差异是否在当代治疗环境中持续存在。方法:对HCA医疗保健企业数据仓库中诊断为重度单极抑郁症(ICD-10代码F32-F33)的患者进行回顾性研究,这些患者在2016年至2021年期间在162家住院和门诊机构中的任何一家就诊。患者根据自我报告的种族-民族身份进行分组。采用卡方检验(α=0.05)确定种族与所选协变量之间的关系,在给定所选预测变量的情况下,采用logistic回归估计种族与ECT接受度之间的关系。结果:对19011例特殊患者进行了分析。结论:在这项全国性的研究中,即使在人口统计学协变量得到控制后,根据自我认同的种族-民族身份,电痉挛疗法的使用也存在显著差异。
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来源期刊
Psychiatric services
Psychiatric services 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.80
自引率
7.90%
发文量
295
审稿时长
3-8 weeks
期刊介绍: Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.
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