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TABLE 1

Characteristics of Florida and Texas Medicaid Children and Adolescents Prescribed an Antipsychotic with Metabolic Monitoring Classification Calendar Year 2017

CharacteristicFlorida (N = 13 078)Texas (N = 28 000)Florida and Texas (N = 41 078)
Behavioral health condition (groups not mutually exclusive), n (%)    
 Schizophrenia 913 (7.0) 1993 (7.1) 2906 (7.1) 
 Autism without irritability 2712 (20.7) 4088 (14.6) 6800 (16.6) 
 Autism with irritability 443 (3.4) 679 (2.4) 1122 (2.7) 
 Bipolar 2395 (18.3) 6973 (24.9) 9368 (22.8) 
 ADHD without conduct disorder 7183 (54.9) 16 854 (60.2) 24 037 (58.5) 
 ADHD with conduct or disruptive behavioral disorder 1051 (8.0) 2970 (10.6) 4021 (9.8) 
 Conduct or disruptive behavioral disorder, no ADHD 407 (3.1) 816 (2.9) 1223 (3.0) 
 Anxiety or depression 4359 (33.3) 13 395 (47.8) 17 754 (43.2) 
 Trauma and stressor and/or adjustment related disorder 2692 (20.6) 6396 (22.8) 9088 (22.1) 
 Other mental health disorder 5204 (39.8) 13 974 (49.9) 19 178 (46.7) 
 None of the above diagnoses 784 (6.0) 1559 (5.6) 2343 (5.7) 
Behavioral health diagnosis is accepted condition for use of antipsychotics, n (%) 5961 (45.6) 12 991 (46.4) 18 952 (46.1) 
Any cardiometabolic diagnosis,an (%) 2175 (16.6) 5611 (20.0) 7786 (19.0) 
Enrolled in foster care, n (%) 2021 (15.5) 3811 (13.6) 5832 (14.2) 
During the year, ≥1 visit, n (%)   
 PCP 4006 (30.6) 8890 (31.8) 12 896 (31.4) 
 MHP 1564 (12.0) 1765 (6.3) 3329 (8.1) 
 PCP and MHP 7508 (57.4) 17 345 (62.0) 24 853 (60.5) 
Majority prescribing provider, n (%)    
 PCPb 3986 (30.5) 9366 (33.5) 13 352 (32.5) 
  Pediatrician 1052 (26.4) 3135 (33.4) 4187 (31.3) 
  Family medicine 110 (2.8) 878 (9.4) 988 (7.4) 
  Internal medicine 50 (1.3) 122 (1.3) 172 (1.3) 
  ARNP 2179 (54.7) 3822 (40.8) 6001 (44.9) 
  PA 563 (14.1) 1381 (14.7) 1944 (14.6) 
 MHP 7801 (59.7) 16 708 (59.7) 24 509 (59.7) 
 Other 1291 (9.9) 1926 (6.9) 3217 (7.8) 
Age, mean (SD; range) 12.6 (3.2; 3–17) 12.0 (3.4; 3–17) 12.2 (3.3; 3–17) 
Female sex, n (%) 4613 (35.2) 9752 (34.8) 14 365 (35.0) 
Race and/or ethnicity, n (%)    
 Black (Non-Hispanic) 1727 (13.2) 4224 (15.1) 5951 (14.5) 
 Hispanic 1677 (12.8) 11 080 (39.6) 12 757 (31.1) 
 Other 521 (4.0) 120 (0.4) 641 (1.6) 
 Unknown 5008 (38.3) 6575 (23.5) 11 583 (28.2) 
 White (Non-Hispanic) 4145 (31.7) 6001 (21.4) 10 146 (24.7) 
RUCC, n (%)    
 Rural (4–9) 484 (3.7) 3430 (12.3) 3914 (9.5) 
 Small or medium metropolitan (2–3) 4893 (37.4) 8559 (30.6) 13 452 (32.8) 
 Urban (1) 7701 (58.9) 16 011 (57.2) 23 712 (57.8) 
SVI, n (%)    
 Fourth quartile (Most vulnerable) 2796 (21.4) 7599 (27.1) 10 395 (25.3) 
 Third quartile 3076 (23.4) 7206 (25.7) 10 282 (25.0) 
 Second quartile 3666 (28.0) 6605 (23.6) 10 271 (25.0) 
 First quartile (least vulnerable) 3540 (27.1) 6590 (23.5) 10 130 (24.7) 
CharacteristicFlorida (N = 13 078)Texas (N = 28 000)Florida and Texas (N = 41 078)
Behavioral health condition (groups not mutually exclusive), n (%)    
 Schizophrenia 913 (7.0) 1993 (7.1) 2906 (7.1) 
 Autism without irritability 2712 (20.7) 4088 (14.6) 6800 (16.6) 
 Autism with irritability 443 (3.4) 679 (2.4) 1122 (2.7) 
 Bipolar 2395 (18.3) 6973 (24.9) 9368 (22.8) 
 ADHD without conduct disorder 7183 (54.9) 16 854 (60.2) 24 037 (58.5) 
 ADHD with conduct or disruptive behavioral disorder 1051 (8.0) 2970 (10.6) 4021 (9.8) 
 Conduct or disruptive behavioral disorder, no ADHD 407 (3.1) 816 (2.9) 1223 (3.0) 
 Anxiety or depression 4359 (33.3) 13 395 (47.8) 17 754 (43.2) 
 Trauma and stressor and/or adjustment related disorder 2692 (20.6) 6396 (22.8) 9088 (22.1) 
 Other mental health disorder 5204 (39.8) 13 974 (49.9) 19 178 (46.7) 
 None of the above diagnoses 784 (6.0) 1559 (5.6) 2343 (5.7) 
Behavioral health diagnosis is accepted condition for use of antipsychotics, n (%) 5961 (45.6) 12 991 (46.4) 18 952 (46.1) 
Any cardiometabolic diagnosis,an (%) 2175 (16.6) 5611 (20.0) 7786 (19.0) 
Enrolled in foster care, n (%) 2021 (15.5) 3811 (13.6) 5832 (14.2) 
During the year, ≥1 visit, n (%)   
 PCP 4006 (30.6) 8890 (31.8) 12 896 (31.4) 
 MHP 1564 (12.0) 1765 (6.3) 3329 (8.1) 
 PCP and MHP 7508 (57.4) 17 345 (62.0) 24 853 (60.5) 
Majority prescribing provider, n (%)    
 PCPb 3986 (30.5) 9366 (33.5) 13 352 (32.5) 
  Pediatrician 1052 (26.4) 3135 (33.4) 4187 (31.3) 
  Family medicine 110 (2.8) 878 (9.4) 988 (7.4) 
  Internal medicine 50 (1.3) 122 (1.3) 172 (1.3) 
  ARNP 2179 (54.7) 3822 (40.8) 6001 (44.9) 
  PA 563 (14.1) 1381 (14.7) 1944 (14.6) 
 MHP 7801 (59.7) 16 708 (59.7) 24 509 (59.7) 
 Other 1291 (9.9) 1926 (6.9) 3217 (7.8) 
Age, mean (SD; range) 12.6 (3.2; 3–17) 12.0 (3.4; 3–17) 12.2 (3.3; 3–17) 
Female sex, n (%) 4613 (35.2) 9752 (34.8) 14 365 (35.0) 
Race and/or ethnicity, n (%)    
 Black (Non-Hispanic) 1727 (13.2) 4224 (15.1) 5951 (14.5) 
 Hispanic 1677 (12.8) 11 080 (39.6) 12 757 (31.1) 
 Other 521 (4.0) 120 (0.4) 641 (1.6) 
 Unknown 5008 (38.3) 6575 (23.5) 11 583 (28.2) 
 White (Non-Hispanic) 4145 (31.7) 6001 (21.4) 10 146 (24.7) 
RUCC, n (%)    
 Rural (4–9) 484 (3.7) 3430 (12.3) 3914 (9.5) 
 Small or medium metropolitan (2–3) 4893 (37.4) 8559 (30.6) 13 452 (32.8) 
 Urban (1) 7701 (58.9) 16 011 (57.2) 23 712 (57.8) 
SVI, n (%)    
 Fourth quartile (Most vulnerable) 2796 (21.4) 7599 (27.1) 10 395 (25.3) 
 Third quartile 3076 (23.4) 7206 (25.7) 10 282 (25.0) 
 Second quartile 3666 (28.0) 6605 (23.6) 10 271 (25.0) 
 First quartile (least vulnerable) 3540 (27.1) 6590 (23.5) 10 130 (24.7) 

ADHD, attention-deficit/hyperactivity disorder; ARNP, advanced registered nurse practitioner; PA, physician’s assistant.

a

≥1 of the following diagnoses: obesity, morbid obesity, overweight, abnormal weight gain, metabolic syndrome, hypertension, elevated blood pressure without hypertension, hyperlipidemia, acquired acanthosis nigricans, hyperinsulinism, impaired fasting glucose, hypercholesteremia, impaired glucose tolerance, hypertriglyceridemia, mixed hyperlipidemia, type 2 diabetes, and nonalcoholic fatty liver disease.

b

PCP subspecialty percentages are among those whose majority prescribing provider is a PCP.

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