Factors associated with the type of psychotropic medications purchased for common mental disorders in the largest managed care organization in Israel.
OBJECTIVE
To evaluate patient and physician characteristics associated with the type of psychotropic medications (anti-anxiety, antidepressant, or both) purchased.


METHODS
The Clalit Health Care Services is the largest managed care health fund in Israel, a country that employs a universal healthcare system. We randomly sampled 30,000 primary care patients over the age of 22 as of January, 2006.


RESULTS
Overall, 2,217 purchased either antidepressant or antianxiety medications at least once during the year 2006 and had no prior purchases during the last quarter of 2005. The majority (1,518; 68.4%) purchased only anti-anxiety medications and as many as 264 (12%) purchased both anti-anxiety and antidepressant medications. The remaining 435 (19.6%) patients purchased only antidepressant medications. Physician level characteristics explained only a small portion of the variance and, thus, were not included in further analysis. Several patient level characteristics, including age, somatic, and psychiatric diagnosis were associated with the purchase of different types of medications.


CONCLUSIONS
Contrary to clinical guidelines, the purchase of anti-anxiety medications is more prevalent than the purchase of antidepressant medications. In a managed care setting, patient characteristics have a greater role in determining purchasing patterns than provider characteristics; potentially, because of the managed care characteristics that actively guide the care provided to patients.
School of Social Work, Bar Ilan University, Israel. liatayalon0@gmail.com
Liat
L
Ayalon
Revital
R
Gross
Aviv
A
Yari
Elan
E
Feldhamer
Ran D
RD
Balicer
Margalit
M
Goldfracht
D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000208:ethnology / Q000401:mortality; D018912:Arabs / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel; D007585:Jews / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy* / Q000208:ethnology / Q000401:mortality; D009313:National Health Programs / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D015996:Survival Rate
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents