Health care supply and county-level variation in attention-deficit hyperactivity disorder prescription medications
Health care supply and county-level variation in attention-deficit hyperactivity disorder prescription medications
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DOI：
10.1002/pds.2264
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发表时间：
2012-04-01
影响因子：
2.6
通讯作者：
Scheffler, Richard M.
中科院分区：
文献类型：
--
作者：
Bruckner, Tim A.;Hodgson, Ashley;Scheffler, Richard M.
目的虽然许多文献报道了用于治疗注意缺陷多动障碍（ADHD）的药物处方的小范围变化，但很少有研究探讨可能导致这种变化的因素。我们检查，在美国的各县，是否使用处方药治疗ADHD的变化与供应侧的医疗保健特征积极。方法我们检索了2001-2003年美国2734个县的ADHD药物处方数据，这些数据来自全国代表性的35000家药店。我们使用县级多变量固定效应分析来估计医疗保健供应的年度变化与ADHD药物处方之间的关系。方法控制每个县特有的时不变因素以及ADHD患病率。结果从2001年到2003年，ADHD药物的零售处方购买增加了33.2%。在多变量分析中，ADHD药物处方随着总医生浓度的增加而正向移动。此外，ADHD药物处方与非西班牙裔黑人人口百分比的变化呈反比。结论供应方的医疗保健因素可能有助于从2001年至2003年ADHD药物处方的上升。这一发现值得关注，因为它意味着医疗保健系统的相对能力可能会影响人口处方率。我们鼓励进一步探索医疗保健市场供应方对ADHD药物处方长期变化的贡献。版权所有（C）2011约翰威利父子有限公司
Purpose Although much literature reports small-area variation in medication prescriptions used to treat attention-deficit hyperactivity disorder (ADHD), scant research has examined factors that may drive this variation. We examine, across counties in the USA, whether the use of prescription medications to treat ADHD varies positively with supply-side healthcare characteristics. Methods We retrieved annual prescription data for ADHD medications in 2734 US counties from a nationally representative sample of 35 000 pharmacies in 2001-2003. We used a county-level, multivariable fixed effects analysis to estimate the relation between annual changes in healthcare supply and ADHD medication prescriptions. Methods controlled for time-invariant factors unique to each county as well as ADHD prevalence. Results From 2001 to 2003, retail prescription purchases for ADHD medications increased 33.2%. In the multivariable analysis, ADHD medication prescriptions move positively with an increase in the concentration of total physicians. In addition, ADHD medication prescriptions move inversely with changes in the percentage of non-Hispanic Black population. Conclusions Supply-side healthcare factors may contribute to the rise from 2001 to 2003 in ADHD medication prescriptions. This finding warrants attention because it implies that the relative capacity of the healthcare system may influence population prescription rates. We encourage further exploration of the contribution of the supply-side of the healthcare market to secular changes in ADHD medication prescriptions. Copyright (C) 2011 John Wiley & Sons, Ltd.