TABLE 3

Logistic Regression With Random Effects Predicting Medicaid-Reimbursed Psychotropic Medication Use Among Children With ASDs (N = 60 641)

ParameterAdjusted OR (95% CI)P
Female0.94 (0.90–0.98).0093
Age (reference is 0- to 2-y-olds), y
    3–51.88 (1.56–2.28)<.0001
    6–114.88 (4.05–5.88)
    12–178.01 (6.63–9.68)
    18–219.77 (8.00–11.93)
Race/ethnicity (reference is white)
    Black0.78 (0.73–0.83)<.0001
    Hispanic0.92 (0.84–1.00)
    Asian0.76 (0.63–0.92)
    Other0.92 (0.87–0.98)
Medicaid eligibility reason (reference is poverty)
    Disability1.48 (1.40–1.57)<.0001
    Foster care2.18 (1.99–2.40)
    Other0.86 (0.74–1.00)
Had an inpatient stay2.38 (2.16–2.62)<.0001
No. of ASD-related Medicaid claims (reference is lowest quartile)
    Second quartile1.36 (1.28–1.44)<.0001
    Third quartile1.60 (1.51–1.70)
    Fourth quartile1.83 (1.72–1.95)
ASD diagnosis (reference is 299.8)
    Autistic disorder (299.0)0.78 (0.74–0.82)<.0001
Other diagnoses
    No other psychiatric diagnosis0.71 (0.65–0.79)<.0001
    Schizophrenia3.26 (2.44–4.37)<.0001
    Bipolar disorder3.55 (2.90–4.33)<.0001
    Depression2.14 (1.85–2.49)<.0001
    Attention-deficit disorder4.62 (4.23–5.04)<.0001
    Anxiety disorder1.73 (1.46–2.05)<.0001
    Conduct disorder1.90 (1.75–2.07)<.0001
    Mental retardation<.0001
        Mild0.93 (0.83–1.04)
        Moderate1.33 (1.19–1.47)
        Severe1.38 (1.23–1.54)
% in county living in urban areas (reference is lowest quartile)
    Second quartile1.09 (0.99–1.19).0374
    Third quartile0.97 (0.84–1.12)
    Fourth quartile0.90 (0.74–1.11)
Median county income (reference is lowest quartile)
    Second quartile1.03 (0.94–1.13).8376
    Third quartile1.04 (0.94–1.16)
    Fourth quartile1.04 (0.93–1.17)
Pediatricians per capita in county (reference is lowest quartile)
    Second quartile0.94 (0.86–1.02).1347
    Third quartile0.91 (0.81–1.02)
    Fourth quartile0.84 (0.72–0.98)
Pediatric specialists per capita (reference is lowest quartile)
    Second quartile1.03 (0.94–1.12).8811
    Third quartile0.99 (0.88–1.12)
    Fourth quartile0.99 (0.85–1.16)
% white within the county (reference is lowest quartile)
    Second quartile1.23 (1.08–1.40).0047
    Third quartile1.23 (1.07–1.42)
    Fourth quartile1.32 (1.12–1.54)
County ASD Medicaid penetration (reference is lowest quartile)
    Second quartile1.01 (0.93–1.11).8529
    Third quartile1.01 (0.91–1.11)
    Fourth quartile0.96 (0.84–1.10)
State ASD special education penetration (reference is lowest quartile)
    Second quartile0.95 (0.83–1.10).8111
    Third quartile0.94 (0.82–1.09)
    Fourth quartile0.96 (0.81–1.15)
Census region (reference is Midwest)
    Northeast0.84 (0.60–1.18).1152
    South1.02 (0.76–1.38)
    West0.74 (0.54–1.01)
  • OR indicates odds ratio; CI, confidence interval.