Racial differences in behavioral inpatient diagnosis: examining the mechanisms using the 2004 Florida Inpatient...

This study used the 2004 Florida Inpatient Discharge Data to examine the existence and the underlying mechanisms of the African American (AA)/white differences in behavioral inpatient diagnosis across a diverse patient population. Findings suggest that discharges of AA patients in Florida were at least twice as likely to have received a primary psychotic vs. affective or substance-related diagnosis, and this held true after between-hospital differences were controlled for. Furthermore, AA (vs. white) race was associated with a ratio of 3.3 in the population rate of hospitalization with a primary psychotic diagnosis, as compared to a ratio of 0.8 and 0.7 for affective and substance-related disorders, respectively. These findings demonstrated the wide existence of racial differences in behavioral inpatient diagnosis and the important role of clinician diagnostic behaviors as opposed to systems-level factors (such as racial differences in access to care and care-seeking behaviors) in leading to observed differences.