Racial and Ethnic Differences in Antipsychotic Medication Use Among Children Enrolled in Medicaid

Area of Science:

• Child Psychiatry
• Health Services Research
• Pharmacological Treatments

Background:

• Antipsychotic medication use in children has increased.
• Racial-ethnic disparities in child healthcare are a significant concern.
• Understanding patterns of psychotropic medication use is crucial for equitable care.

Purpose of the Study:

• To examine racial-ethnic variations in antipsychotic drug prescriptions among children enrolled in Medicaid.
• To quantify differences in the likelihood of antipsychotic fills and psychiatric service utilization across racial-ethnic groups.

Main Methods:

• Analysis of Medicaid MAX data (2005-2009) for 5.8 million children (ages 2-20) in eight states.
• Utilized proportional hazard and ordinary least-squares regression models.
• Assessed the impact of race-ethnicity on antipsychotic prescription fills and psychiatric service use.

Main Results:

• White children exhibited significantly higher antipsychotic drug use compared to Hispanic, Asian, and African American children.
• Minority children had a lower probability of antipsychotic fills (1.8-2.0 percentage points lower) and reduced psychiatric service utilization.
• These disparities are notable given the overall low probability (2.4%) of antipsychotic prescription fills.

Conclusions:

• Significant racial-ethnic disparities exist in pediatric antipsychotic medication use.
• Socio-cultural factors like treatment aversion do not fully explain these observed differences.
• Further research is needed to address the underlying causes of these disparities in child mental healthcare.