title: Racial differences in antipsychotic use: Claims database analysis of Medicaid-insured patients with schizophrenia.
abstract: BACKGROUND
  Database analyses have indicated that medical treatment for schizophrenia varies among racial groups. This study assessed antipsychotic use and healthcare utilization across races in Medicaid-insured patients with schizophrenia.
  
  
  METHODS
  A Medicaid database of inpatient/outpatient medical claims and outpatient prescription claims for more than 28 million enrollees in 11 geographically diverse states was analyzed. The primary outcome, racial differences in antipsychotic use in 2012, was examined in 5 multivariable logistic regression models: (1) any antipsychotic, (2) first-generation (FG) long-acting injectables (LAIs), (3) FG oral antipsychotics, (4) second-generation (SG) LAIs, and (5) SG oral antipsychotics.
  
  
  RESULTS
  Odds ratios and adjusted predicted probabilities were comparable for any antipsychotic use between black and white patients. Black patients were less likely to receive SG oral antipsychotics (P < .001) and more likely to receive SG or FG LAIs (P = .001 and P < .001, respectively) and FG oral antipsychotics (P = .003) vs white patients. Further, black patients had a higher mean number of emergency room visits (P < .001) and a lower mean number of hospitalizations (P < .05) vs white patients; the mean number of physician visits was comparable.
  
  
  CONCLUSIONS
  Disparities in antipsychotic use and healthcare utilization across races in patients with schizophrenia warrant further investigation and elimination of these disparities should be a national goal.
authors.affiliation: University of Texas at Austin, Austin, TX USA.
authors.forename: William
authors.initials: W
authors.lastname: Lawson
authors.forename: Stephen
authors.initials: S
authors.lastname: Johnston
authors.forename: Craig
authors.initials: C
authors.lastname: Karson
authors.forename: Steve
authors.initials: S
authors.lastname: Offord
authors.forename: John
authors.initials: J
authors.lastname: Docherty
authors.forename: Anna
authors.initials: A
authors.lastname: Eramo
authors.forename: Siddhesh
authors.initials: S
authors.lastname: Kamat
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Blanchette
authors.forename: William
authors.initials: W
authors.lastname: Carson
authors.forename: Henry A
authors.initials: HA
authors.lastname: Nasrallah
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D044383:Black People / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy*; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American
chemical_list: D014150:Antipsychotic Agents