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Exploring the variation in state-level prescription utilization using a triangulation of analytic methods
Mustafa Hussein1, Lawrence M Brown2
1Health Outcomes and Policy Research (HOPR) Graduate Program, The University of Tennessee Health Science Center, Memphis, TN, USA.
Research in Social & Administrative Pharmacy : RSAP
|March 27, 2014
Summary
State prescription drug use varies widely. Higher utilization is linked to more Medicaid/private insurance and nurse practitioners, but less physical activity. Chronic conditions also play a role.
Area of Science:
- Health Services Research
- Pharmaceutical Policy
- Public Health
Background:
- State-level prescription drug utilization shows significant variation, with rates differing substantially across the US.
- Empirical investigations into the drivers of this wide variation in prescription fills have been limited.
Purpose of the Study:
- To identify factors contributing to the observed disparities in prescription drug utilization across different US states.
- To explore the relationship between sociodemographic, health, insurance, and provider characteristics and prescription fill rates.
Main Methods:
- Utilized pooled cross-sectional data from 2008-2010 for all 50 states and DC.
- Employed multivariable regression models (linear, negative binomial, ordered logit) to analyze prescription utilization.
- Incorporated principal components analysis to manage multicollinearity among explanatory variables.
Main Results:
- Higher prescription utilization correlated with increased employer-sponsored insurance and Medicaid coverage.
- Greater density of nurse practitioners was associated with higher utilization; higher physician density showed an inverse relationship.
- Increased physical activity was linked to lower prescription use, while chronic conditions affected utilization levels but not high-utilization likelihood.
Conclusions:
- Variations in provider types, insurance coverage (Medicaid/private), and chronic disease prevalence appear to influence state prescription drug utilization.
- Further research is recommended to elucidate the specific mechanisms through which these factors impact state-level prescription patterns.
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