Thesis
Factors associated with the prescription of antipsychotics: Medicare utilization and costs in 2004
Washington State University
Master of Health Policy and Administration (MHPA), Washington State University
2009
Handle:
https://hdl.handle.net/2376/105486
Abstract
Objective: To determine whether the use of typical, atypical, or combination antipsychotics vary by patient attributes, and whether the type of antipsychotic medication affects the utilization and costs of healthcare services. Methods: The cross-sectional study is conducted by using the data from the 2004 Medicare Current Beneficiary Survey (MCBS). The antipsychotic users are divided into two groups: 1) typical antipsychotics only, and 2) atypical antipsychotics (with or without concurrent use of typical antipsychotics). Bivariate and multivariate analyses examine how predisposing, enabling, and need factors influence Medicare beneficiaries' receipt of typical and atypical prescriptions, and examine the effects that typical and atypical antipsychotic medications have on total prescribed medication events, inpatient admission rates, outpatient visits, and costs. Results: An estimated 1.26 million Medicare beneficiaries filled one or more antipsychotic prescriptions in 2004. Hispanics, those eligible for Medicaid and Medicare, Medicare HMO enrollees, and those with fair or poor health are at highest risk of receiving typical antipsychotics. The costs of prescribed medicine, inpatient costs, and total health costs are substantially higher for atypical users in the Medicare population. Discussion: Prescriptions for atypical antipsychotics outpace prescriptions for typical antipsychotics. This study found ethnic disparities for antipsychotic users among Medicare beneficiaries. Insofar as atypical agents are the treatment of choice, it is crucial that providers are aware of these disparities and provide the appropriate medications to all patients. In addition, atypical antipsychotics are associated with higher hospitalization rates which could have important implications for clinical practice. It is possible that atypical agents are simply not as efficacious as initially thought. Some metabolic side effects induced by atypical agents might aggravate health conditions other than mental illness, leading to hospitalization for cardiac conditions, diabetes related problems, or other chronic conditions. Additional research that attempts to control for these factors is urgently need.
Metrics
3 File views/ downloads
11 Record Views
Details
- Title
- Factors associated with the prescription of antipsychotics
- Creators
- Yu-Yu Tien
- Contributors
- Jae Kennedy (Degree Supervisor)
- Awarding Institution
- Washington State University
- Academic Unit
- Health Policy and Administration, Department of
- Theses and Dissertations
- Master of Health Policy and Administration (MHPA), Washington State University
- Publisher
- Washington State University; Pullman, Wash. :
- Identifiers
- 99900525117001842
- Language
- English
- Resource Type
- Thesis