Table 2.
Demographic, Behavioral Health Characteristics, and Comorbidities by Level of Prior Authorization
| Characteristics | Total n (%) | High Prior Authorization n (%) |
Low prior authorization n (%) |
No prior authorization n (%) |
|---|---|---|---|---|
| Patient Level a | 297,634 (100.0) | 103,587 (34.8) | 33,270 (11.2) | 160,777 (54.0) |
| Demographics | ||||
| Age, y | ||||
| 18–29 | 140,876 (47.3) | 50,946 (49.2) | 13,619 (40.9) | 76,311 (47.5) |
| 30–39 | 66,258 (22.3) | 23,366 (22.6) | 7,188 (21.6) | 35,704 (22.2) |
| 40–49 | 47,584 (16.0) | 15,696 (15.2) | 6,130 (18.4) | 25,758 (16.0) |
| 50–64 | 42,916 (14.4) | 13,579 (13.1) | 6,333 (19.0) | 23,004 (14.3) |
| Female | 212,209 (71.3) | 73,891 (71.3) | 23,568 (70.8) | 114,750 (71.4) |
| Race | ||||
| White | 167,175 (56.2) | 79,965 (77.2) | 5,418 (16.3) | 81,792 (50.9) |
| Black | 83,874 (28.2) | 14,641 (14.1) | 15,950 (47.9) | 53,283 (33.1) |
| Hispanic | 35,885 (12.1) | 6,416 (6.2) | 10,386 (31.2) | 19,083 (11.9) |
| Other | 10,700 (3.6) | 2,565 (2.5) | 1,516 (4.6) | 6,619 (4.1) |
| Urban | 252,087 (84.7) | 65,948 (63.7) | 33,226 (99.9) | 152,913 (95.1) |
| Type of eligibility | ||||
| GA | 32,256 (10.8) | 9,162 (8.8) | 5,075 (15.3) | 18,019 (11.2) |
| SSI | 86,785 (29.2) | 31,167 (30.1) | 10,702 (32.2) | 44,916 (27.9) |
| TANF | 178,593 (60.0) | 63,258 (61.1) | 17,493 (52.6) | 97,842 (60.9) |
| Medicaid region | ||||
| Region 1 | 54,475 (18.3) | 13,233 (12.8) | 112 (0.3) | 41,130 (25.6) |
| Region 2 | 38,602 (13.0) | 36,791 (35.5) | 74 (0.2) | 1,737 (1.1) |
| Region 3 | 26,861 (9.0) | 23,346 (22.5) | 8 (0.0) | 3,507 (2.2) |
| Region 4 | 104,890 (35.2) | 8,780 (8.5) | 33,044 (99.3) | 63,066 (39.2) |
| Region 5 | 72,806 (24.5) | 21,437 (20.7) | 32 (0.1) | 51,337 (31.9) |
| Episode-level b (N=382,828) | ||||
| Behavioral and Mental Health | ||||
| Alcohol use disorder | 9,973 (2.6) | 3,342 (2.6) | 978 (2.3) | 5,653 (2.7) |
| Drug use disorder | 8,795 (2.3) | 2,383 (1.8) | 1,058(2.5) | 5,354 (2.5) |
| Adjustment disorders | 8,509 (2.2) | 3,274 (2.5) | 810 (1.9) | 4,425 (2.1) |
| Anxiety disorders | 39,604 (10.4) | 13,958 (10.8) | 4,102 (9.5) | 21,544 (10.2) |
| Mood disorders | 84,437 (22.1) | 28,332 (21.9) | 10,970 (25.5) | 45,135 (21.4) |
| Personality disorders | 2,034 (0.5) | 847 (0.7) | 109 (0.3) | 1,078 (0.5) |
| Miscellaneous mental health disorders | 12,082 (3.2) | 3,957 (3.1) | 1,522 (3.5) | 6,603 (3.1) |
| Painful Conditions and Healthcare Utilization | ||||
| Back pain | 67,346 (17.6) | 22,971 (17.8) | 8,294 (19.3) | 36,081 (17.1) |
| Neck pain | 23,822 (6.2) | 8,246 (6.4) | 2,738 (6.4) | 12,838 (6.1) |
| HIV/AIDS | 3,525 (0.9) | 495 (0.4) | 878 (2.0) | 2,152 (1.0) |
| Arthritis/joint pain | 76,691 (20.0) | 25,312 (19.6) | 9,468 (22.0) | 41,911 (19.9) |
| Headache/migraine pain | 15,514 (4.1) | 5,722 (4.4) | 1,380 (3.2) | 8,412 (4.0) |
| ED visit | 180,045 (47.0) | 59,237 (45.8) | 20,528 (47.7) | 100,280 (47.6) |
| Medication Use | ||||
| Benzodiazepine use | 55,986 (14.6) | 18,287 (14.2) | 7,317 (17.0) | 30,383 (14.4) |
| Muscle relaxant use | 36,597 (9.6) | 12,555 (9.7) | 4,484 (10.4) | 19,558 (9.3) |
| Comorbidity | ||||
| Elixhauser indexc | 1.12 (1.62) | 1.07 (1.57) | 1.42 (1.84) | 1.09 (1.59) |
a
Measured at the person level, N=297,634;
b
Measured at the event-level, N=382,828;
c
mean (standard deviation)