Racial and ethnic differences in mental health service utilization among the Hawaii medicaid population

Abstract

Background: Racial/ethnic differences have not been adequately addressed in the utilization of mental health services among Medicaid populations.

Aim: This study aimed to examine racial/ethnic differences in the utilization of health services for mental disorders in a Medicaid adult population aged between 21 and 64 years.

Methods: Racial/ethnic differences in inpatient, outpatient and emergency department services utilization were assessed using 2010 Hawaii Medicaid data. Zero-inflated negative binomial regressions were employed adjusting for age, sex and residential area.

Results: Among 73,200 beneficiaries, 29.7% were Whites, 28.5% Asians, 34.7% Native Hawaiians and Pacific Islanders (NHPIs); 60.2% were younger (21–44 years) and 58.6% were females. The patterns of utilization of health services differed across race/ethnicity. Compared to Whites, Asians and NHPIs were less likely to use outpatient services and had lower rates of inpatient visits. NHPIs were also estimated to have lower rates of outpatient and emergency department visits.

Conclusion: Variation in the utilization of health services emphasizes the importance of race/ethnicity in mental health management. Various factors, such as language barriers and cultural differences, should be considered in developing clinical interventions or integrative health programs that aim to reduce racial/ethnic disparities among people with mental disorders.

Keywords:

• Race
• ethnicity
• utilization
• Medicaid
• mental disorder

Acknowledgements

The authors thank Dr. Jill Miyamura of the Hawaii Health Information Corporation for providing access to the Hawaii Medicaid database. The authors thank Ms. Munirih Taafaki for reviewing and editing the manuscript.

Disclosure statement

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

National Center on Minority Health and Health Disparities Research, U54MD007584 (RMATRIX) and U54MD007601 (Ola Hawaii); National Institutes of General Medical Sciences, P20GM103466 (INBRE) and U54GM104944 (CTR-IN).

All the above funding sources are from two sub-institutes of the National Institutes of Health (NIH), National Center on Minority Health and Health Disparities Research and National Institutes of General Medical Sciences under NIH. More detailed information of funding can be obtained from the website https://taggs.hhs.gov/Detail/RecipDetail?arg_RecipId=ivVqE2gny%2FirDEUQS4ohJg%3D%3D.