Racial differences in visit duration of outpatient psychiatric visits.
BACKGROUND
Substantial racial disparities exist in the delivery of some health care services. Whether racial disparities exist in the duration of office visits to psychiatrists is not known.


OBJECTIVE
To compare the duration of visits to office-based psychiatrists by white and African American patients.


METHODS
Analysis of a nationally representative sample of visits to office-based psychiatrists between 2001 and 2006. Visits were grouped by patient race as non-Hispanic African American (n = 504) or non-Hispanic white (n = 7094). Main Outcome Measure Duration of face-to-face contact between patient and psychiatrist.


RESULTS
Unadjusted mean duration of psychiatric outpatient visits by African Americans (mean duration, 28.3 minutes) were 4.4 minutes shorter than visits by whites (32.7 minutes) (P = .02), although the difference narrowed (3.5 minutes; P = .07) following adjustment for potentially confounding patient, psychiatrist, and practice characteristics. A gap was evident in 2001-2003 (7.4 minutes; P <.001) but negligible in 2004-2006 (0.1 minute; P = .94). In stratified regressions that combined time periods and controlled for several relevant characteristics, significant racial differences in visit duration were observed among visits with the following characteristics: adjustment disorder diagnosis (10.0 minutes; P <.001), female patient sex (5.4 minutes; P = .008), depressive disorder diagnosis (5.2 minutes; P = .04), solo practice (5.2 minutes; P = .04), psychotherapy provision (5.1 minutes; P = .01), practices with high patient volume (5.0 minutes; P = .03), Medicare payment (3.5 minutes; P = .02), and absence of psychiatric comorbidity (3.3 minutes; P = .04).


CONCLUSIONS
In recent years, progress has been made in closing a racial gap in the length of psychiatric office-based outpatient visits by African American vs white patients. Against a backdrop of persisting racial disparities in other areas of mental health care, ongoing attention to reducing disparities will be necessary to sustain and extend these gains.
Olfson
Mark
M
Department of Psychiatry, Division of Epidemiology, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. mo49@columbia.edu
Cherry
Donald K
DK
Lewis-Fernández
Roberto
R
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D008875:Middle Aged; D011570:Psychiatry / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012737:Sex Factors; D013997:Time Factors; D014481:United States; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*
D011619:Psychotropic Drugs