不同风险特征的重度酗酒成年人在接受专业治疗方面的种族和民族差异。

IF 3 Q2 SUBSTANCE ABUSE
Vanessa A. Palzes, Felicia W. Chi, Constance Weisner, Andrea H. Kline-Simon, Derek D. Satre, Stacy Sterling
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引用次数: 0

摘要

背景:人们对患者亚群在酒精使用障碍(AUD)专科治疗利用率方面的差异知之甚少。本研究探讨了患者的风险特征是否以及如何预测接受专科治疗的情况,以及是否存在种族和民族差异:这项队列研究纳入了 2013 年 6 月 1 日至 2014 年 12 月 31 日期间大量饮酒(超过美国国家酒精滥用和酒精中毒研究所指南的饮酒量)的 206956 名成人,研究使用的是北加州凯泽医疗机构的电子健康记录数据。通过潜类分析确定了五种风险特征(以每日或每周大量饮酒和健康风险水平为特征)。在对其他患者特征进行调整后,拟合了逻辑回归模型,以检验风险特征、种族、民族和接受专科治疗(包括成瘾医学、精神病学或综合行为健康就诊以及 AUD 药物治疗)之间的关联。此外,还研究了不同种族/族裔的风险特征与接受专科治疗之间的关联差异:结果:总体而言,4.0% 的患者接受了专科治疗。拉丁裔/西班牙裔和亚太裔患者接受专科治疗的几率低于白人患者(调整后的几率比 [aOR] [95% CI] 分别为 0.80 [0.75, 0.85] 和 0.64 [0.59, 0.70])。药物使用障碍和精神健康障碍(SUD/MH)风险特征接受专科治疗的几率最高(10.46 [9.65, 11.34])。不同种族/族裔的风险特征与接受专科治疗之间的关系存在显著差异。属于 SUD/MH 风险特征的黑人患者,以及属于每日大量饮酒且健康风险较高风险特征的西班牙裔/拉丁美洲裔患者,接受专科治疗的几率低于白人患者(调整后的几率比 [aROR] [95% CI] = 0.69 [0.50, 0.94] 和 0.79 [0.67, 0.92]):本研究为了解酗酒问题专科治疗利用率的种族/民族差异提供了新的视角。研究结果可能有助于为制定干预策略提供依据,以解决酗酒问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Racial and ethnic disparities in receipt of specialty treatment across risk profiles of adults with heavy alcohol use

Racial and ethnic disparities in receipt of specialty treatment across risk profiles of adults with heavy alcohol use

Racial and ethnic disparities in receipt of specialty treatment across risk profiles of adults with heavy alcohol use

Background

Variation in specialty treatment utilization for alcohol use disorder (AUD) by patient subgroups is poorly understood. This study examined whether and how patient risk profiles predict receipt of specialty treatment and whether there are disparities by race and ethnicity.

Methods

This cohort study included 206,956 adults with heavy alcohol use (that which exceeded National Institute on Alcohol Abuse and Alcoholism guidelines) between June 1, 2013 and December 31, 2014, using electronic health record data from Kaiser Permanente Northern California. Five risk profiles (characterized by daily or weekly heavy drinking and level of health risks) were identified in latent class analysis. Logistic regression models were fit to examine associations between risk profiles, race, ethnicity, and receipt of specialty treatment (including addiction medicine, psychiatry, or integrated behavioral health visits, and AUD pharmacotherapy), adjusting for other patient characteristics. Variation in the association between risk profiles and receipt of specialty treatment by race/ethnicity was also examined.

Results

Overall, 4.0% of patients received specialty treatment. Latino/Hispanic and Asian/Pacific Islander patients had lower odds of receiving specialty treatment than White patients (adjusted odds ratio [aOR] [95% CI] = 0.80 [0.75, 0.85], and 0.64 [0.59, 0.70], respectively). The substance use disorder and mental health disorder (SUD/MH) risk profile had the highest odds of receiving specialty treatment (10.46 [9.65, 11.34]). Associations between risk profiles and receipt of specialty treatment significantly differed by race/ethnicity. Black patients in the SUD/MH risk profile, and Hispanic/Latino patients in the risk profile with heavy daily drinking and more health risks, had lower odds of receiving specialty treatment than their White counterparts (adjusted ratio of odds ratios [aROR] [95% CI] = 0.69 [0.50, 0.94], and 0.79 [0.67, 0.92], respectively).

Conclusions

This study provides new insights into racial/ethnic disparities in specialty treatment utilization for alcohol problems. Findings may help inform strategies for tailoring interventions to address heavy alcohol use.

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