Related Experiment Video

Updated: Apr 16, 2026

Development of a Virtual Reality Assessment of Everyday Living Skills

Development of a Virtual Reality Assessment of Everyday Living Skills

Published on: April 23, 2014

Where You Live Matters: Quality and Racial/Ethnic Disparities in Schizophrenia Care in Four State Medicaid Programs

Marcela Horvitz-Lennon¹, Rita Volya², Rachel Garfield³

¹RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA.

Health Services Research

|March 12, 2015

Abstract

Objective:

To determine whether (a) quality in schizophrenia care varies by race/ethnicity and over time and (b) these patterns differ across counties within states.

Data Sources:

Medicaid claims data from California, Florida, New York, and North Carolina during 2002-2008.

Study Design:

We studied black, Latino, and white Medicaid beneficiaries with schizophrenia. Hierarchical regression models, by state, quantified person and county effects of race/ethnicity and year on a composite quality measure, adjusting for person-level characteristics.

Principal Findings:

Overall, our cohort included 164,014 person-years (41-61 percent non-whites), corresponding to 98,400 beneficiaries. Relative to whites, quality was lower for blacks in every state and also lower for Latinos except in North Carolina. Temporal improvements were observed in California and North Carolina only. Within each state, counties differed in quality and disparities. Between-county variation in the black disparity was larger than between-county variation in the Latino disparity in California, and smaller in North Carolina; Latino disparities did not vary by county in Florida. In every state, counties differed in annual changes in quality; by 2008, no county had narrowed the initial disparities.

Conclusions:

For Medicaid beneficiaries living in the same state, quality and disparities in schizophrenia care are influenced by county of residence for reasons beyond patients' characteristics.

Keywords:

Medicaid geographic variation quality of care racial/ethnic disparities schizophrenia

More Related Videos

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects

Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects

Published on: May 10, 2019

Related Concept Videos

Psychological and Sociocultural Causes of Schizophrenia

Psychological and Sociocultural Causes of Schizophrenia

Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...

Drug Therapy

Drug Therapy

The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications

Psychosis: Goals of Pharmacotherapy

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.

Standards of Care I

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:

Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders

Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders

Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...

Methods of Documentation VI: Case Management Model

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...

Articles linked to this work by shared authors, journal, and citation graph.

Bounding causal effects with an unknown mixture of informative and non-informative missingness.

Journal of causal inference·2026

The Behavioral Health Treatment Engagement and Retention Learning Collaborative to Improve Receipt and Continuity of Medication Treatment for Opioid Use Disorder.

Substance use & addiction journal·2026

Elevating Patient Voices to Improve Opioid Use Disorder Quality Measurement: A Survey Protocol.

Substance use & addiction journal·2026

Factors associated with long-term suicide risk severity among youth in community behavioral health care.

Journal of affective disorders·2026

Continuity of Medications for Opioid Use Disorder in States With and Without Medicaid Prescription Cap Policies.

Medical care·2026

Methodological innovations to advance substance use disorder research: Proceedings of a NIDA workshop on target trial emulation and translational testing of digital health tools.

Journal of substance use and addiction treatment·2026

See all related articles