Table 1.
Numbers & Percentages of Medication Use Among Medicaid Beneficiaries with Newly-Diagnosed Chronic Obstructive Pulmonary Disease, Medicaid Analytic Extract, 2005–2008
| Any AD use | Any statin use | Any ICS use | |||||||
|---|---|---|---|---|---|---|---|---|---|
| n | Row % | Sig. | n | Row % | Sig. | n | Row % | Sig. | |
| Total | 7313 | 47.8 | 3720 | 24.3 | 6554 | 41.4 | |||
| Cohort | * | ||||||||
| 2005–2007 | 4148 | 48.0 | 2041 | 23.6 | 3746 | 43.4 | |||
| 2006–2008 | 3165 | 47.6 | 1679 | 25.3 | 2808 | 42.2 | |||
| Sex | *** | *** | *** | ||||||
| Women | 4853 | 54.6 | 2299 | 25.9 | 4209 | 47.4 | |||
| Men | 2460 | 38.4 | 1421 | 22.2 | 2345 | 36.6 | |||
| Race/ethnicity | *** | *** | *** | ||||||
| White | 4121 | 53.9 | 2005 | 26.2 | 3372 | 44.1 | |||
| African American | 1527 | 37.6 | 755 | 18.6 | 1645 | 40.5 | |||
| Others | 1665 | 46.6 | 960 | 26.9 | 1537 | 43.0 | |||
| Age (in years) | *** | *** | |||||||
| 40–49 | 2787 | 51.9 | 934 | 17.4 | 2262 | 42.1 | |||
| 50–59 | 3470 | 47.6 | 1883 | 25.8 | 3129 | 42.9 | |||
| 60–64 | 1056 | 40.3 | 903 | 34.4 | 1163 | 44.4 | |||
| State | *** | *** | *** | ||||||
| California | 4055 | 48.0 | 2100 | 24.9 | 3481 | 41.2 | |||
| Illinois | 1548 | 48.0 | 764 | 23.7 | 1455 | 45.1 | |||
| New York | 1104 | 51.8 | 566 | 26.5 | 1188 | 55.7 | |||
| Texas | 606 | 40.8 | 290 | 19.5 | 430 | 29.0 | |||
| Income eligibility | ** | *** | * | ||||||
| Yes | 6753 | 48.2 | 3471 | 24.8 | 5976 | 42.7 | |||
| No | 560 | 43.7 | 249 | 19.4 | 578 | 45.1 | |||
| Medical eligibility | *** | ||||||||
| Yes | 814 | 48.1 | 338 | 20.0 | 740 | 43.7 | |||
| No | 6499 | 47.8 | 3382 | 24.9 | 5814 | 42.8 | |||
| Inflammation-related multimorbidity | *** | *** | |||||||
| Physical only | 2601 | 40.0 | 2087 | 32.1 | 2787 | 42.8 | |||
| Mental only | 1011 | 78.8 | 184 | 14.3 | 567 | 44.2 | |||
| Both | 2245 | 81.4 | 846 | 30.7 | 1216 | 44.1 | |||
| None | 1456 | 30.7 | 603 | 12.7 | 1984 | 41.9 | |||
| Number of other clinical conditions | *** | *** | *** | ||||||
| None | 135 | 30.6 | 61 | 13.8 | 143 | 32.4 | |||
| 1–3 | 1209 | 37.9 | 641 | 20.1 | 1244 | 39.0 | |||
| 4–6 | 1618 | 42.8 | 894 | 23.6 | 1579 | 41.7 | |||
| >6 | 4351 | 55.3 | 2124 | 27.0 | 3588 | 45.6 | |||
| Serious mental illness | *** | *** | *** | ||||||
| Yes | 2514 | 62.2 | 856 | 21.2 | 1403 | 34.7 | |||
| No | 4799 | 42.7 | 2864 | 25.5 | 5151 | 45.8 | |||
| Alcohol abuse | *** | *** | *** | ||||||
| Yes | 828 | 53.4 | 217 | 14.0 | 569 | 36.7 | |||
| No | 6485 | 47.2 | 3503 | 25.5 | 5985 | 43.6 | |||
| Substance abuse | *** | *** | |||||||
| Yes | 1286 | 57.3 | 295 | 13.1 | 950 | 42.3 | |||
| No | 6027 | 46.2 | 3425 | 26.3 | 5604 | 43.0 | |||
| Tobacco use | *** | *** | |||||||
| Yes | 1176 | 56.7 | 439 | 21.2 | 922 | 44.5 | |||
| No | 6137 | 46.4 | 3281 | 24.8 | 5632 | 42.6 | |||
| Polypharmacy | *** | *** | *** | ||||||
| Yes | 4559 | 65.2 | 2629 | 37.6 | 3720 | 53.2 | |||
| No | 2754 | 33.2 | 1091 | 13.1 | 2834 | 34.2 | |||
| ARF variables (county level) | |||||||||
| Above HS education density | *** | *** | *** | ||||||
| Q1 | 3621 | 45.6 | 1999 | 25.2 | 3239 | 40.8 | |||
| Q2 | 1107 | 50.2 | 552 | 25.0 | 943 | 42.7 | |||
| Q3 | 1593 | 50.1 | 767 | 24.1 | 1449 | 45.6 | |||
| Q4 | 992 | 50.5 | 402 | 20.5 | 923 | 47.0 | |||
| Unemployment density | *** | * | *** | ||||||
| Q1 | 5263 | 46.5 | 2734 | 24.1 | 4683 | 41.3 | |||
| Q2 | 1068 | 51.1 | 541 | 25.9 | 964 | 46.1 | |||
| Q3 | 741 | 52.1 | 318 | 22.4 | 686 | 48.3 | |||
| Q4 | 241 | 53.8 | 127 | 28.3 | 221 | 49.3 | |||
| Poverty density | ** | ** | *** | ||||||
| Q1 | 647 | 50.5 | 270 | 21.1 | 585 | 45.7 | |||
| Q2 | 1080 | 48.9 | 501 | 22.7 | 953 | 43.2 | |||
| Q3 | 1409 | 49.8 | 689 | 24.4 | 1286 | 45.5 | |||
| Q4 | 4177 | 46.6 | 2260 | 25.2 | 3730 | 41.6 | |||
| Metro | *** | ||||||||
| Yes | 6222 | 47.0 | 3202 | 24.2 | 5673 | 42.9 | |||
| No | 1091 | 53.3 | 518 | 25.3 | 881 | 43.0 | |||
| PCP shortage | * | ||||||||
| Yes | 7003 | 47.8 | 3586 | 24.5 | 6288 | 42.9 | |||
| No | 310 | 49.5 | 134 | 21.4 | 266 | 42.5 | |||
| Mental health specialist shortage | *** | *** | |||||||
| Yes | 6457 | 47.3 | 3313 | 24.3 | 5750 | 42.1 | |||
| No | 856 | 52.1 | 407 | 24.8 | 804 | 48.9 | |||
| PCP density | *** | *** | |||||||
| Q1 | 321 | 50.8 | 161 | 25.5 | 326 | 51.6 | |||
| Q2 | 1335 | 51.7 | 674 | 26.1 | 1147 | 44.4 | |||
| Q3 | 1136 | 51.8 | 527 | 24.0 | 1025 | 46.7 | |||
| Q4 | 4521 | 45.8 | 2358 | 23.9 | 4056 | 41.1 | |||
| Hospital bed density | *** | ** | *** | ||||||
| Q1 | 432 | 53.9 | 203 | 25.3 | 401 | 50.1 | |||
| Q2 | 1230 | 49.2 | 560 | 22.4 | 1092 | 43.6 | |||
| Q3 | 3983 | 46.4 | 2168 | 25.2 | 3440 | 40.0 | |||
| Q4 | 1668 | 49.2 | 789 | 23.3 | 1621 | 47.8 | |||
| Psychiatric hospital | *** | ||||||||
| Yes | 4497 | 46.2 | 2395 | 24.6 | 4132 | 42.5 | |||
| No | 2816 | 50.7 | 1325 | 23.9 | 2422 | 43.6 | |||
| Pulmonologist density | *** | * | *** | ||||||
| High | 4913 | 45.9 | 2546 | 23.8 | 4346 | 40.6 | |||
| Low | 2400 | 52.3 | 1174 | 25.6 | 2208 | 48.1 | |||
| Cardiologist density | *** | *** | |||||||
| High | 4601 | 46.1 | 2401 | 24.1 | 4094 | 41.0 | |||
| Low | 2712 | 51.1 | 1319 | 24.9 | 2460 | 46.4 | |||
Based on 15,287 Medicaid beneficiaries with newly diagnosed COPD and who were diabetes free during the baseline period obtained from Medicaid analytic extract files observed during 2005–2008. Asterisks represent significant group differences in beneficiary characteristics by medication use obtained from chi-square test.
***
P < 0.001; **0.001 ≤ P < 0.01; *0.01 ≤ P < 0.05.
AD, antidepressant; ARF, area resource file; COPD, chronic obstructive pulmonary disease; HS, high school; ICS, inhaled corticosteroid; PCP, primary care provider; Q, quarter; Sig., significance.