TABLE 2

Medicaid-Reimbursed Psychotropic Medication Use Among Children With ASDs According to County and State Characteristics (N = 60 641)

ParameterAny Psychotropic Medication, %≥3 Concurrent Psychotropics, %Psychotropic Medication Class, %
AntidepressantNeurolepticAnxiolyticMood StabilizerSedativeStimulant
% of county living in urban areasa
    First quartile (0%–63%)611230321324326
    Second quartile (64%–87%)601229331423325
    Third quartile (88%–98%)561126321223321
    Fourth quartile (99%–100%)4671526816318
Median county household income
    First quartile ($16 435–$35 574)611227321423426
    Second quartile ($35 575–$40 274)52923271018323
    Third quartile ($40 275–$44 360)55921321121319
    Fourth quartile ($44 394–$93 316)561127311222321
Pediatricians per capita by countya
    First quartile (0.00–0.32 per 1000)621330331324326
    Second quartile (0.33–0.52 per 1000)581228321322324
    Third quartile (0.53–0.86 per 1000)50921271019320
    Fourth quartile (0.87–4.56 per 1000)55921311120320
Pediatric specialists per capita by countya
    First quartile (0.00–0.02 per 1000)611230331424425
    Second quartile (0.03–0.12 per 1000)601228331323324
    Third quartile (0.13–0.23 per 1000)4892027918320
    Fourth quartile (0.24–4.32 per 1000)55922321121320
% white by county
    First quartile (5%–56%)4661525815318
    Second quartile (57%–76%)591125341323423
    Third quartile (77%–90%)591228331324424
    Fourth quartile (91%–99%)601231311223325
ASD Medicaid penetration by countya
    First quartile (0.04–0.58 per 1000)581227351324421
    Second quartile (0.59–0.95 per 1000)581126331223322
    Third quartile (0.96–1.79 per 1000)591229311322325
    Fourth quartile (1.80–32.5 per 1000)4881925916321
ASD education penetration by statea
    First quartile (0.002–0.011 per 1000)4692025917219
    Second quartile (0.012–0.030 per 1000)56922321121321
    Third quartile (0.031–0.107 per 1000)601128331323424
    Fourth quartile (0.108–15.400 per 1000)621230341324426
Census regiona
    Midwest (n = 18 557)53102628921224
    Northeast (n = 12 447)55922321120420
    South (n = 18 735)611226331523426
    West (n = 10 898)521025301121316
  • a Statistically significant at P < .0002 based on random-effects model to account for clustering by county and state.