238203 Race/ethnic differences in receipt of evidence based treatment for depression among medicaid enrolled adults in Florida

Wednesday, November 2, 2011: 12:50 PM

Marion Ann Becker, PhD , Aging and Mental Health Disparities, University of South Florida, Tampa, FL
Timothy Boaz, PhD , Mental Health Law and Policy, University of South Florida, Tampa, FL
Ross Andel, PhD , School of Aging Studies, University of South Florida, Tampa, FL
Objective: The purpose of this study was to examine race/ethnicity differences in receipt of evidence based treatment for depression among Florida's Medicaid enrolled adults over age 18 with Major depressive disorder (MDD). We also examined the relationship between receipt of evidence based treatment, recipient outcomes and Medicaid expenditures.

Methods: This retrospective study used two and a half years of Medicaid claims, involuntary psychiatric commitment, and vital statistics data. We used regression analyses to determine the relative importance of race/ethnicity and other predictive factors for adherence to the APA guidelines for MDD and the relationship of service utilization and cost.

Results: In all, 15,950 persons met inclusion criteria. MDD increased with age. A little over three fourths (75.6 %) of the sample were female. Approximately 37.2% were identified as White, 9% as Black, 42.3% as Hispanic, and 11.5 as “Other”. Only 33% of participants received treatment that conformed to the APA guidelines. Overall, Hispanics were most likely to receive medication treatment that adhered to guidelines, while Whites were least likely. Blacks, Hispanics and those of Other race were likely to receive below APA dosing range of antidepressants when compared to Whites. Whites were more likely to receive polypharmacy (3+ antidepressants) while Blacks had the highest overall monthly healthcare costs.

Conclusions: Nonadherence to APA guidelines for MDD was the norm rather than the exception and race/ethnic disparities were found in treatment of MDD. These findings provide a basis for future research and clinical training initiatives.

Learning Areas:
Administer health education strategies, interventions and programs
Diversity and culture
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1) Discuss the use of evidence based practice for treatment of major depressive disorder (MDD). 2) Describe the relationship between EBP adherence for MDD and healthcare costs 3) list the strengths and limitations of using administrate data and 4) Describe racial/ethnic variation in the use of EBPs.

Keywords: Evidence Based Practice, Mental Health Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the principal investigator on the study and am a mental health clinician for many years
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.