Racial Differences in Treatment Received and in Treatment Completed
Racial and ethnic minorities may be less likely than others to complete treatment for alcohol dependence. In this study, researchers assessed whether racial/ethnic differences in type of treatment received (outpatient or residential) could explain differences in treatment completion rates. They analyzed the discharge data of 10,591 patients (4141 African Americans, 3120 Hispanics, and 3330 whites) treated in the publicly funded programs of a large, urban county in California.
- The rate for completing outpatient treatment was lowest among African Americans (18%), followed by whites (27%) and Hispanics (30%). The rate of completing residential treatment was also lowest among African Americans (31%), followed by Hispanics (43%) and whites (46%).
- In analyses adjusted for potential confounders, African Americans (odds ratio [OR], 1.9) and Hispanics (OR, 2.1) were more likely than whites to enter outpatient (versus residential) treatment.
- Further analyses indicated that if minority patients in outpatient care had the same probability of receiving residential treatment as did white patients with otherwise similar characteristics, the disparity in completion rates would improve for African Americans and resolve for Hispanics.
This study showed that completion rates for outpatient and residential alcohol treatment were low among all racial/ethnic groups but lowest among African Americans. Even if African Americans had an equal probability as whites of entering residential treatment, they would still be less likely to complete treatment. This study is unable to determine whether racial and ethnic minorities should be steered to residential alcohol treatment. But, it does underscore the need to improve the retention and completion rates of patients with alcohol dependence, especially African Americans, enrolled in publicly funded alcohol treatment programs.Kevin L. Kraemer, MD, MSc
Bluthenthal RN, Jacobson JO, Robinson PL. Are racial disparities in alcohol treatment completion associated with racial differences in treatment modality entry? Comparison of outpatient treatment and residential treatment in Los Angeles County, 1998 to 2000. Alcohol Clin Exp Res. 2007;31(11):1920–1926.