Patterns of Health Care Utilization Before First Episode Psychosis in Racial and Ethnic Groups

Ethn Dis. 2019 Oct 17;29(4):609-616. doi: 10.18865/ed.29.4.609. eCollection 2019 Fall.

Abstract

Objective: To compare patterns of health care utilization associated with first presentation of psychosis among different racial and ethnic groups of patients.

Design: The study was a retrospective observational design.

Setting: The study was conducted in five health care systems in the western United States. All sites were also part of the National Institute of Mental Health-funded Mental Health Research Network (MHRN).

Participants: Patients (n = 852) were aged 15 - 59 years (average 26.9 ± 12.2 years), 45% women, and primarily non-Hispanic White (53%), with 16% Hispanic, 10% non-Hispanic Black, 6% Asian, 1% Native Hawaiian/Pacific Islander, 1% Native American/ Alaskan Native, and 12% unknown race/ethnicity.

Main outcome measures: Variables examined were patterns of health care utilization, type of comorbid mental health condition, and type of treatment received in the three years before first presentation of psychosis.

Methods: Data abstracted from electronic medical records and insurance claims data were organized into a research virtual data warehouse (VDW) and used for analysis.

Results: Compared with non-Hispanic Whites, Asian patients (16% vs 34%; P=.007) and non-Hispanic Black patients (20% vs 34%; P=.009) were less likely to have a visit with specialty mental health care before their first presentation of psychosis.

Conclusions: Early detection of first episode psychosis should start with wider screening for symptoms outside of any indicators for mental health conditions for non-Hispanic Black and Asian patients.

Keywords: First Episode Psychosis; Mental Health Research Network; Virtual Data Warehouse.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Asian / statistics & numerical data
  • Black or African American / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Indians, North American / statistics & numerical data
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Psychotic Disorders / diagnosis*
  • Retrospective Studies
  • United States
  • White People / statistics & numerical data
  • Young Adult