Search

Objectives. Factors affecting ethnic differences in the use of out-patient mental health services are analyzed in an insured, nonpoor population to determine if lower use by Blacks and Hispanics persists when socioeconomic and other factors are controlled. Methods. To identify significant predictors of the probability and amount of use, insurance claims data for a population of 1.2 million federal employees insured by Blue Cross/ Blue Shield in 1983 were analyzed with the Andersen and Newman model of health service utilization. Logistic and ordinary least squares regression models were estimated for each ethnic group. Results. Blacks and Hispanics had lower probabilities and amounts of use when compared with Whites after controlling for a number of variables. Conclusions. Since ethnic differences in the use of outpatient mental health services exist even in an insured, nonpoor population, factors other than lower socioeconomic status or insurance coverage - for example, cultural or attitudinal factors and service system barriers - are likely responsible. Such findings have policy implications in the current climate of health care reform to increase access to care for the underserved. (Am J Public Health. 1994;84: 222-226), Whites tend to use outpatient mental health services more than other ethnic groups even when insurance coverage is similar among groups. Information from insurance claims filed by 1.2 million federal employees and their families was analyzed. Two options for mental health coverage were available through the health insurance plan. The high-option plan had a lower deductible, a higher copayment and a maximum of 50 mental health visits per year. The low-option plan had a slightly higher deductible, a lower copayment and a maximum of 25 mental health visits. Fifty-eight percent of whites and approximately 75% of blacks and Hispanics chose the high-option plan. Fewer blacks used outpatient mental health services than any other group. Hispanics used outpatient mental health services slightly more often than blacks but had a lower average number of visits. Whites used the mental health services most frequently and had the highest average number of visits. Of women, those on the high-option plan, the more educated and those between 18 and 45 years old had higher rates of mental health service use.