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This study examines variations in psychotropic drug use among children enrolled in Medicaid during 1995 in two midwestern states. A dataset was created from Kansas Medicaid prescription reimbursement claims and enrollment files that included age, gender, ethnicity, diagnoses, and drugs prescribed for each of the 5,574 children under age 20 years who received at least one psychotropic drug prescription in 1995. A similar database composed of information on 41,031 children from another midwestern state was used for comparisons between the two states. We found that boys were far more likely to receive psychotropic drug prescriptions than were girls. The overall ratio of male to female psychotropic drug users is highest among younger children and nearly equal among older adolescents. While African-American and Hispanic children represented 23% and 12%, respectively, of all children enrolled in Medicaid, they accounted for only 12% and 3.5% of psychotropic drug users, respectively. The striking differences in psychotropic drug use found suggest that patient gender may influence diagnosis and treatment in a way that physiological differences alone cannot account for. Ethnic disparities found here indicate possible access problems or underdiagnoses for minority children. Future efforts to improve the mental health of young people must include attempts to identify the causes of these disparities....
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