Med
Care 1999 Nov;37(11):1092-104
Comment in:
Med Care.
1999 Nov;37(11):1089-91.
Patient race and ethnicity in primary care management of child behavior
problems: a report from PROS and ASPN. Pediatric Research in Office Settings.
Ambulatory Sentinel Practice Network.
Kelleher KJ, Moore CD, Childs GE, Angelilli ML, Comer DM.
Children's Hospital of Pittsburgh and the University of Pittsburgh, Pennsylvania,
USA.
BACKGROUND: Minority persons have less access to many
specialty treatments and services, possibly because of clinician biases.
It is not clear whether any such biases exist in primary care settings,
especially for children with psychosocial problems.
OBJECTIVES: The objective was to compare primary care
recognition and treatment of pediatric psychosocial problems among African
American, Hispanic American and European American patients.
DESIGN: A survey was made of parents and respective clinicians
in primary care offices in two large practice-based research networks
(PROS and ASPN) from 44 states, Canada, and Puerto Rico. Mixed regression
analyses were employed to control for patient, clinician, and practice
effects.
SUBJECTS: The subjects were 14,910 children aged 4 to
15 years seen consecutively for non-emergent care by 286 primary care
clinicians in office-based practice.
MEASURES: Measures were parents' report for sociodemographics
and behavioral symptoms using the Pediatric Symptom Checklist, and clinicians'
report of psychosocial problems, type, management, and severity.
RESULTS: Of the sample, 8.0% were African American youth,
9.5% were Hispanic American youth, and 82.5% were European American youth.
After controlling for other factors, race and ethnicity were not associated
with any differences in psychotropic drug prescribing, counseling, referral,
or recognition of psychosocial problems. Clinicians reported spending
slightly more time with minority patients.
CONCLUSION: Race and ethnic status were not related
to receipt of mental health services for children in primary care offices,
suggesting that clinician biases may not be the primary cause of the racial
differences in services noted earlier research. Improving services for
minority youth may require increasing access to office-based primary care.
PMID: 10549612 [PubMed - indexed for MEDLINE]
Med Care 1999 Nov;37(11):1089-91
Comment on:
Med
Care. 1999 Nov;37(11):1092-104.
Patient race and ethnicity in primary care management of child behavior
problems: an important nonfinding.
Landsverk J.
Publication Types: Comment, Editorial
PMID: 10549611 [PubMed - indexed for MEDLINE]
