An Economic & Policy Analysis of ADHD & Stimulant Drugs

经济

• 批准号: 6724734
• 负责人: RICHARD M SCHEFFLER
• 金额: $ 33.87万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-06 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6724734
• 关键词: adolescence (12-20); attention deficit disorder; central nervous system stimulants; child (0-11); health care cost /financing; health care policy; health economics; human data; managed care; mental disorder chemotherapy; psychopharmacologic agent

DESCRIPTION (provided by applicant): This research provides an economic and policy analysis of the variation in psycho-stimulant use for Attention Deficit Hyperactivity Disorder (ADHD). ADHD is the most commonly diagnosed behavioral disorder in children. According to a 2002 Centers for Disease Control (CDC) report, roughly 3.5 percent of school-age children in the U.S. have an ADHD diagnosis, and over half of those diagnosed with ADHD take psycho-stimulant medication regularly. Use of these drugs varies considerably, up to three-fold across states and ten-fold within states. The main goal of this project is to understand the economic and policy sources of these dramatic variations. Using aggregate data and different definitions of local markets, we examine the sources of variation in the consumption rates across the continental U.S. The market models are used to test hypotheses regarding the effects of economic, demographic (e.g. age, sex, race, ethnicity), state regulatory, school policy, health system, and other educational variables on the supply and demand for psycho-stimulants. Examples of policy variables of interest include state level regulations on substitution and refilling of prescription drugs, Schedule II drug monitoring programs, as well as school accountability laws. We then repeat the analysis using more detailed data on consumption rates in California. This sub-analysis explains the variation within gender and age groups and the impact of differences in educational policies at the school district level. Next, we study the sources of variation in individual-level cost and utilization patterns using longitudinal data from Kaiser-Permanente Northern California. We use the Kaiser data to examine the effects of personal characteristics (age, gender, race/ethnicity, birth weight, mother's age at birth), and local area characteristics (economic, demographic, medical and insurance market and school district education policies) on costs of treating children with ADHD diagnoses. Additionally we use the Kaiser data to examine the effects of these variables on "spells" of psycho-stimulant use, including effects on the initiation, discontinuation, and restarting of psycho-stimulant drugs. In this study we will sort through the economic and policy factors influencing the large variation in psycho-stimulant use across the U.S. By furthering the understanding of this variation, the results will inform policymakers, health professionals, educators, and families with school-age children.

描述（由申请人提供）：这项研究提供了对注意力缺陷多动障碍（ADHD）的心理刺激使用变化的经济和政策分析。多动症是儿童中最常见的行为障碍。根据2002年疾病控制中心（CDC）报告，在美国，大约3.5％的学龄儿童患有ADHD诊断，而被诊断为多动症的患者中有一半定期服用心理刺激药物。这些药物的使用差异很大，在各州之间最多三倍，在州内部有十倍。该项目的主要目标是了解这些戏剧性变化的经济和政策来源。使用汇总数据和本地市场的不同定义，我们研究了美国大陆上消费率的差异来源。市场模型用于测试有关经济，人口统计学（例如年龄，性别，性别，种族，种族，种族），州监管，学校政策，卫生政策，健康系统以及其他教育变量对精神病患者的供应和需求的假设。感兴趣的政策变量的示例包括有关替代和补充处方药的州一级法规，附表II药物监测计划以及学校问责法。然后，我们使用加利福尼亚州消费率的更详细的数据重复分析。该亚分析解释了性别和年龄段的差异以及学区一级教育政策差异的影响。接下来，我们使用Kaiser-permanente北加州的纵向数据研究了个体成本和利用模式的差异来源。我们使用Kaiser数据来研究个人特征（年龄，性别，种族/种族，出生体重，出生时母亲的年龄）以及当地特征（经济，人口统计，医疗和保险市场以及学区教育保单）对治疗ADHD诊断儿童的成本的影响。此外，我们使用Kaiser数据来检查这些变量对精神刺激使用“法术”的影响，包括对启动，停用和重新启动心理刺激药物的影响。在这项研究中，我们将通过进一步了解这种差异的理解来介绍影响整个美国精神刺激使用巨大差异的巨大差异的经济和政策因素，结果将为决策者，卫生专业人员，教育工作者和具有学龄儿童的家庭提供信息。