Associations of Patient Race and Ethnicity With Emergency Department Disposition for Mental Health Visits in the United States

Nina Gao, MD, PhD; Mark Olfson, MD, MPH

J Clin Psychiatry 2023;84(5):22m14661

ABSTRACT

Objective: To describe associations between patient race and ethnicity with emergency department disposition for mental health visits in the United States.

Methods: We identified 674,821 visits for mental health in the 2019 National Emergency Department Sample and classified them by ICD-10 diagnostic group: schizophrenia-spectrum, bipolar, major depressive, anxiety, or other disorders. Racial and ethnic categories were White, Black, Hispanic, or other. Logistic regression models, adjusted for age, sex, insurance status, and medical comorbidities, were used to describe differences in odds of inpatient admission by race/ethnicity and diagnosis.

Results: After covariate adjustment, we did not find overall differences in the likelihood of admission between racial/ethnic groups. However, compared to White patients, admission rates were lower for visits by Black patients for bipolar disorder (OR = 0.71; 95% CI, 0.59–0.84) and major depressive disorder (OR = 0.70; 95% CI, 0.59–0.83) and lower for Hispanic patients (OR = 0.57; 95% CI, 0.47–0.68) for anxiety disorders. There were no significant racial/ethnic differences in admission rates for schizophrenia-spectrum disorders.

Conclusions: Overall admission rates were comparable for Black and White patients. After covariate adjustment, there were no differences across racial/ethnic groups, though some racial/ethnic differences persisted within diagnostic subsets of mood and anxiety disorders.

J Clin Psychiatry 2023;84(5):22m14661

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