This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Medical Practice, Other  • Psychotherapy  • Psychiatry, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Mark Olfson, MD, MPH; Donald K. Cherry, MS; Roberto Lewis-Fernández, MD

Arch Gen Psychiatry. 2009;66(2):214-221.

Context  Substantial racial disparities exist in the delivery of some health care services. Whether racial disparities exist in the duration of office visits to psychiatrists is not known.

Objective  To compare the duration of visits to office-based psychiatrists by white and African American patients.

Design, Setting, and Participants  Analysis of a nationally representative sample of visits to office-based psychiatrists between 2001 and 2006. Visits were grouped by patient race as non-Hispanic African American (n = 504) or non-Hispanic white (n = 7094).

Main Outcome Measure  Duration of face-to-face contact between patient and psychiatrist.

Results  Unadjusted mean duration of psychiatric outpatient visits by African Americans (mean duration, 28.3 minutes) were 4.4 minutes shorter than visits by whites (32.7 minutes) (P = .02), although the difference narrowed (3.5 minutes; P = .07) following adjustment for potentially confounding patient, psychiatrist, and practice characteristics. A gap was evident in 2001-2003 (7.4 minutes; P <.001) but negligible in 2004-2006 (0.1 minute; P = .94). In stratified regressions that combined time periods and controlled for several relevant characteristics, significant racial differences in visit duration were observed among visits with the following characteristics: adjustment disorder diagnosis (10.0 minutes; P <.001), female patient sex (5.4 minutes; P = .008), depressive disorder diagnosis (5.2 minutes; P = .04), solo practice (5.2 minutes; P = .04), psychotherapy provision (5.1 minutes; P = .01), practices with high patient volume (5.0 minutes; P = .03), Medicare payment (3.5 minutes; P = .02), and absence of psychiatric comorbidity (3.3 minutes; P = .04).

Conclusions  In recent years, progress has been made in closing a racial gap in the length of psychiatric office-based outpatient visits by African American vs white patients. Against a backdrop of persisting racial disparities in other areas of mental health care, ongoing attention to reducing disparities will be necessary to sustain and extend these gains.

Author Affiliations: Department of Psychiatry of New York State Psychiatric Institute at Columbia University, New York (Drs Olfson and Lewis-Fernández); and Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland (Mr Cherry).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

This Month in Archives of General Psychiatry
Arch Gen Psychiatry. 2009;66(2):121.
FULL TEXT