TY - JOUR
KW - Adult
KW - Antidepressive Agents/therapeutic use
KW - Depressive Disorder/ethnology/therapy
KW - European Continental Ancestry Group/psychology
KW - Guideline Adherence
KW - Health Services Accessibility
KW - Health Services Research
KW - Hispanic Americans/psychology
KW - Humans
KW - Logistic Models
KW - Middle Aged
KW - Minority Groups/psychology
KW - Primary Health Care/standards
KW - Total Quality Management/methods
KW - United States
AU - I. T. Lagomasino
AU - M. Dwight-Johnson
AU - J. Miranda
AU - L. Zhang
AU - D. Liao
AU - N. Duan
AU - K. B. Wells
A1 - 
AB - OBJECTIVE: This study examined the impact of patient characteristics and source of care on differences between whites and Latinos in use and quality of depression treatment in managed primary care settings. METHODS: Data were examined for 1,175 patients (398 Latinos and 777 whites) in 46 managed primary care practices who screened positive for probable depressive disorder. Patient baseline assessments were used to compile sociodemographic and clinical characteristics and to derive variables for receipt of any depression care and depression care that met minimum guidelines (antidepressant use or specialty counseling) in the past six months. Clinics were classified by the percentage of their patient population that consisted of Latinos to determine whether patients in highly Latino clinics reported lower rates of care. Predictors of use and quality of depression care were examined by using logistic regression. RESULTS: Rates of receipt of any depression care and guideline-level depression care were low, and Latinos were less than half as likely as whites to receive such care, even after the analyses controlled for independent predictors (that is, younger age, higher educational level, current unemployment, more comorbid medical illness, and a diagnosis of a depressive or anxiety disorder). The likelihood of receiving any care or care that met guidelines did not significantly vary according to whether clinics served a low, moderate, or high percentage of Latinos. CONCLUSIONS: Disparities in depression care for Latinos were not attributable to sociodemographic and clinical characteristics, and they were not attributable to receiving care in clinics that served ethnically similar or dissimilar clientele. These findings suggest that other patient or provider factors may be responsible.
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Disparities
CP - 12
CY - United States
DO - 10.1176/appi.ps.56.12.1517
IS - 12
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: This study examined the impact of patient characteristics and source of care on differences between whites and Latinos in use and quality of depression treatment in managed primary care settings. METHODS: Data were examined for 1,175 patients (398 Latinos and 777 whites) in 46 managed primary care practices who screened positive for probable depressive disorder. Patient baseline assessments were used to compile sociodemographic and clinical characteristics and to derive variables for receipt of any depression care and depression care that met minimum guidelines (antidepressant use or specialty counseling) in the past six months. Clinics were classified by the percentage of their patient population that consisted of Latinos to determine whether patients in highly Latino clinics reported lower rates of care. Predictors of use and quality of depression care were examined by using logistic regression. RESULTS: Rates of receipt of any depression care and guideline-level depression care were low, and Latinos were less than half as likely as whites to receive such care, even after the analyses controlled for independent predictors (that is, younger age, higher educational level, current unemployment, more comorbid medical illness, and a diagnosis of a depressive or anxiety disorder). The likelihood of receiving any care or care that met guidelines did not significantly vary according to whether clinics served a low, moderate, or high percentage of Latinos. CONCLUSIONS: Disparities in depression care for Latinos were not attributable to sociodemographic and clinical characteristics, and they were not attributable to receiving care in clinics that served ethnically similar or dissimilar clientele. These findings suggest that other patient or provider factors may be responsible.
PP - United States
PY - 2005
SN - 1075-2730; 1075-2730
SP - 1517
EP - 1523
EP - 
T1 - Disparities in depression treatment for Latinos and site of care
T2 - Psychiatric services (Washington, D.C.)
TI - Disparities in depression treatment for Latinos and site of care
U1 - Healthcare Disparities
U2 - 16339612
U3 - 10.1176/appi.ps.56.12.1517
VL - 56
VO - 1075-2730; 1075-2730
Y1 - 2005
ER -