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Brief Reports   |    
State and Demographic Variation in Use of Depot Antipsychotics by Medicaid Beneficiaries With Schizophrenia
Jonathan D. Brown, Ph.D., M.H.S.; Allison Barrett, M.A.; Emily Caffery, B.A.; Kerianne Hourihan, B.Sc., B.A.; Henry T. Ireys, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300001
View Author and Article Information

The authors are affiliated with Mathematica Policy Research. Dr. Brown, Ms. Barrett, and Dr. Ireys are with the Washington, D.C., office, Ms. Caffery is with the Ann Arbor, Michigan, office, and Ms. Hourihan is with the Cambridge, Massachusetts, office (e-mail: jbrown@mathematica-mpr.com).

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  This study examined state and demographic variation in use of depot antipsychotics among Medicaid beneficiaries with schizophrenia.

Method  Medicaid claims data (2007) from 21 states and the District of Columbia were analyzed for 102,884 beneficiaries age 18 to 64 with schizophrenia. Rates of receipt of depot antipsychotics were determined for all beneficiaries and for African Americans, Caucasians, and beneficiaries from “all other races.”

Results  Across study states, a mean of 10% of beneficiaries with schizophrenia received depot antipsychotics. Rates ranged from 1.9% in the District of Columbia to 20.9% in Alabama. In 12 states, African Americans were disproportionately likely to receive these medications compared with beneficiaries of other races.

Conclusions  Use of depot antipsychotics varied across state Medicaid programs. African Americans received a disproportionate share in many states. Further research is needed to understand the sources of such variation. These findings underscore the need to monitor the use of depot antipsychotics.

Abstract Teaser
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Anchor for Jump
Table 1Receipt of depot antipsychotics among 102,884 Medicaid beneficiaries with schizophrenia in 21 states and the District of Columbia, by racial-ethnic group
Table Footer Note

a Denominator is all beneficiaries with schizophrenia in each racial group for each state. Data are not reported (nr) for states with fewer than 100 beneficiaries with schizophrenia in a given racial group.

Table Footer Note

b Denominator is beneficiaries with schizophrenia who received depot antipsychotics in each state. Data are not reported (nr) for states with fewer than 100 beneficiaries receiving depot antipsychotics in a given racial group.

Table Footer Note

c “Other” includes Hispanic, American Indian and Native American, and unknown. The number of beneficiaries in these groups was too small to analyze separately.

Table Footer Note

d Percentage point difference from the racial distribution of the Medicaid population with schizophrenia

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