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APHA Scientific Session and Event Listing

Junling Wang, PhD¹, Shelley White-Means, PhD², Meghan Hufstader, BA¹, and Genene D. Walker, MS². (1) Department of Pharmaceutical Sciences; Division of Health Science Administration, University of Tennessee, 847 Monroe Ave., Room 205R, Memphis, TN 38163, 901-448-3601, jwang26@utmem.edu, (2) College of Pharmacy, University of Tennessee Health Science Center, 847 Monroe Avenue Rm 205N, Memphis, TN 38163

Objectives: Prior studies documented racial and ethnic disparities in access to selective serotonin reuptake inhibitors (SSRI). This study explores the effects of these disparities on per capita health expenditures.

Methodology: The main data source was Medical Expenditure Panel Survey (2002-2003), which provided information on patient characteristics, utilization of health services and prescription medications, and health care expenditures. A negative binomial model was used to test the racial and ethnic disparities in SSRI use, controlling for other confounders. SSRI use was measured by the number of times filling prescriptions for SSRIs. A linear regression model was used to test effects of SSRI use on annual per capita health expenditures. Since a test of the interaction terms between racial and ethnic variables and other confounders found at least one significant interaction term, separate analyses were done for each racial and ethnic group in both analyses above.

Results: Among all study observations, 36,814 were non-Hispanic whites, 17,630 were Hispanic whites, 10,664 were non-Hispanic blacks, and 2,653 were non-Hispanic Asians (Hispanic blacks and Hispanic Asians were excluded due to small sample sizes). According to the descriptive analysis, the mean numbers of SSRI use among non-Hispanic whites, Hispanic whites, non-Hispanic blacks, and non-Hispanic Asians were 0.42, 0.11, 0.12, 0.07, respectively. Non-Hispanic whites used more SSRIs than minority populations (P<0.05). After adjusting for confounding factors, the disparities became smaller but non-Hispanic whites still had used almost twice the total number of SSRIs than minority populations. The descriptive analysis showed that the mean per capita health care expenditures were $3348.07, $1578.63, $2523.44, $2233.67, respectively, for non-Hispanic whites, Hispanic whites, non-Hispanic blacks and non-Hispanic Asians. The differences between non-Hispanic whites and two minority groups, non-Hispanic blacks and Hispanic whites, were significant. The effects of SSRI use vary across racial and ethnic groups: each additional use of an SSRI increased the annual per capita health expenditures by more than $400 among non-Hispanic whites, more than $530 among non-Hispanic blacks, and more than $510 among Hispanic whites (P<0.05 for all three groups); each additional SSRI use led to about $100 lower health care expenditure among Asians (P>0.05).

Conclusions: There are disparities in SSRI use across racial and ethnic groups. The findings that SSRI use led to increased health expenditure that vary across racial and ethnic groups may suggest that SSRI use may be associated with enhanced access to health care services among SSRI users, particularly some racial and ethnic minorities.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Understand modeling techniques with the dependent variables being count variables;
• Understand modeling techniques for survey data;
• Devise implications for policy and practice based on the status of racial/ethnic disparities in the use of selective serotonin reuptake inhibitors.

Keywords: Prescription Drug Use Patterns, Minorities

Presenting author's disclosure statement:

Any relevant financial relationships? No