The effect on treatment outcomes of assigning patients to ethnically focused inpatient psychiatric units.
OBJECTIVE
The authors examined whether assigning patients from three ethnic groups-blacks, Latinos, and Asians-to three ethnically focused psychiatric inpatient units would affect treatment outcome.


METHODS
Retrospective administrative data for 5,983 inpatients at a large urban community hospital with several ethnically focused units were examined. The data represented 10,645 admissions between 1989 and 1996. Cox proportional-hazards models, logistic and multinomial regressions, and chi square analyses were used to assess the relationship between matching patients to ethnically focused units and time to rehospitalization, referral destination on discharge, and length of stay for Asian, black, and Latino patients.


RESULTS
Ethnic matching status was strongly associated with referral destination for Asian and Latino patients but not for black patients. Asian and Latino patients who had been treated on the appropriate ethnically focused units were more frequently sent to outpatient or residential treatment (71 to 73 percent of discharges) than unmatched patients, black patients, and white patients (44 to 49 percent of discharges), who more frequently refused follow-up or were sent to locked facilities. No association was found between matching status and time to rehospitalization or length of stay for any ethnic group.


CONCLUSIONS
Matching inpatients to ethnically focused psychiatric units was related to referral destination at discharge. Matched patients were more likely than unmatched patients to accept referral to postdischarge treatment, which has been shown previously to reduce readmission rates. Among persons with serious mental illness, matching patients to ethnically focused units may be important for enhancing communication and trust as a means of improving participation in ongoing treatment programs.
Mathews
Carol A
CA
Department of Psychiatry at the University of California, San Diego, 9500 Gilman Drive, 0810 La Jolla, California 92093-0810, USA. camathews@ucsd.edu
Glidden
David
D
Murray
Stephen
S
Forster
Peter
P
Hargreaves
William A
WA
D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy*; D008875:Middle Aged; D010359:Patient Readmission; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome; D044465:White People / Q000523:psychology