RACIAL DISPARITY IN PSYCHOTROPIC MEDICATIONS PRESCRIBED FOR YOUTHS WITH MEDICAID INSURANCE IN MARYLAND

Design: A retrospective analysis was conducted using state Medicaid pr escription drug reimbursement claims for youths aged 5 through 14 year s according to the race of the recipients of psychotropic and medical drugs. Method: A person-based data set was created from Medicaid admin istrative data for fiscal year 1991 from the state of Maryland to yiel d the following: (1) estimates of prevalence of prescription recipient s per 100 eligible enrollees; (2) relative prescription use ratios acc ording to race (African-American versus Caucasian); and (3) the interr elation of race and geographic region on prescription prevalence. Resu lts: Five major findings were observed: (1) African-American youths wi th Medicaid insurance aged 5 through 14 were less than half (39% to 52 %) as likely to have been prescribed psychotropic medications as Cauca sian youths with Medicaid insurance; (2) the relative difference for n onpsychotropic medication classes was much less pronounced: African-Am erican youths were prescribed nonpsychotropic medications at a rate 60 % to 87% of the Caucasian youths' rate; (3) the stimulants (essentiall y methylphenidate) had the most disparate African-American/Caucasian r atio (1:2.5); (4) the racial disparity for psychotropics was not alter ed by partial (noncontinuous enrollment) eligibility status; and (5) a lthough geographic variation reduced the racial disparity, the substan tial racial difference (1:2.0) remained. Conclusion: Compared with Cau casians, African-American youths aged 5 through 14 with Medicaid insur ance coverage showed a distinctly lower rate of treatment with psychop harmacological agents.