Examining racial disparity in psychotic disorders related ambulatory care visits: an observational study using national ambulatory medical care survey 2010-2015

• Published in: BMC psychiatry 2023-08, Vol.23 (1), p.601-12, Article 601
• Main Authors: Bazargan-Hejazi, Shahrzad, Shirazi, Anaheed, Hampton, David, Pan, Deyu, Askharinam, Daniel, Shaheen, Magda, Ebrahim, Gul, Shervington, Denese
• Format: Article
• Language: English
• Subjects: Age groups; Ambulatory care; Ambulatory Care - statistics & numerical data; Ambulatory care visits; Ambulatory medical care; Analysis; Antidepressants; Asthma; Black or African American; Black People - psychology; Black People - statistics & numerical data; Care and treatment; Chronic obstructive pulmonary disease; Correlation of Data; Cultural differences; Demographic aspects; Diabetes; Diagnosis; Environmental aspects; Epidemiology; Ethnicity; Health care disparities; Health Inequities; Health surveys; Healthcare Disparities - ethnology; Healthcare Disparities - statistics & numerical data; Hispanic Americans; Humans; Inequality; Medicaid; Mental depression; Mental disorders; Mental health; Mental illness; Minority & ethnic groups; Morbidity; Observational studies; Physicians; Population; Psychiatry; Psychosis; Psychotic Disorders; Psychotic Disorders - diagnosis; Psychotic Disorders - epidemiology; Psychotic Disorders - ethnology; Psychotic Disorders - therapy; Psychotropic drugs; Race; Racial differences; Racial disparity; Regression analysis; Schizoaffective disorder; Schizophrenia; Social aspects; Surveys; United States - epidemiology
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-023-05095-y

One of the most consistent research findings related to race and mental health diseases is the disproportionately high rate of psychotic disorder diagnoses among people of color, specifically people of African descent. It is important to examine if a similar pattern exists among specific psychotic disorders. We aimed to examine the racial/ethnic differences in ambulatory care visits diagnosed with schizophrenia-spectrum disorders (SSDs). We analyzed data from the National Ambulatory Medical Care Survey (NAMCS) 2010-2015. The study sample included physician office-based visits by individuals diagnosed with SSDs, including schizophrenia, schizoaffective, and unspecified psychotic disorder (n = 1155). We used descriptive and bivariate analysis by race/ethnicity and three multinomial logistic regression models to test the association between the SSDs and race/ethnicity, adjusting for age, gender, insurance, disposition, medication Rx, and co-morbidity, considering the design and weight. Of the 1155 visits for SSDs, 44.8% had schizophrenia, 37.4% had schizoaffective disorder diagnosis, and 19.0% had unspecified psychosis disorder. We found significant racial disparities in the diagnosis of SSDs. Black patients were overrepresented in all three categories: schizophrenia (24%), schizoaffective disorder (17%), and unspecified psychosis disorder (26%). Also, a notable percentage of Black patients (20%) were referred to another physician in cases of schizophrenia compared to other ethnoracial groups (p