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Papers by Scott Bilder

Research paper thumbnail of Best Practices: MEDNET: A Multistate Policy Maker-Researcher Collaboration to Improve Prescribing Practices

Psychiatric Services, Jan 11, 2014

States face new federal requirements to monitor psychotropic prescribing practices for children a... more States face new federal requirements to monitor psychotropic prescribing practices for children and adults enrolled in Medicaid. Effective use of quality measurement and quality improvement strategies hold the promise of improved outcomes for public mental health systems. The Medicaid/Mental Health Network for Evidence-Based Treatment (MEDNET), funded by the Agency for Healthcare Research and Quality, is a multistate Medicaid quality collaborative with the Rutgers University Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes. This column describes the development, infrastructure, challenges, and early evidence of success of this public-academic partnership, the first multistate Medicaid quality improvement collaborative to focus on psychotropic medications.

Research paper thumbnail of US Patterns of Mental Health Service Utilization for Transition-Age Youth and Young Adults

This study examines rates of admission and patterns of mental health service use by persons of tr... more This study examines rates of admission and patterns of mental health service use by persons of transition age (16-25 years) in the USA based on the nationally representative 1997 Client/Patient Sample Survey and population data from the US Census Bureau. A precipitous decline in utilization was observed at the age of emancipation: the yearly admission rate for inpatient, outpatient, and residential services was 34 per 1,000 for 16-and 17-year-olds and 18 per 1,000 for 18-and 19-year-olds. Among 20-and 21-year-olds, more were referred from criminal justice and fewer from family or friends and social services, and proportionately more were Medicaid Results from preliminary analyses were presented at

Research paper thumbnail of Bipolar Medication Use and Adherence to Antiretroviral Therapy Among Patients With HIV-AIDS and Bipolar Disorder

Psychiatric Services, 2011

The study examined relationships between adherence to bipolar medication and to antiretroviral th... more The study examined relationships between adherence to bipolar medication and to antiretroviral therapy, measured by medication fills, among patients with diagnoses of bipolar disorder and HIV infection. A retrospective study was conducted of Medicaid claims data (2001-2004) from eight states, focusing on antiretroviral adherence. The unit of analysis was person-month (N=53,971). The average observation period for the 1,687 patients was 32 months. Analyses controlled for several patient characteristics. Patients possessed antiretroviral drugs in 72% of the person-months. When a bipolar medication prescription was filled in the prior month, the rate of antiretroviral possession in the subsequent month was 78%, compared with 65% when bipolar medication was not filled in the prior month (p<.001). Odds of antiretroviral possession were 66% higher in months when patients had a prior-month supply of bipolar medication. Bipolar medication adherence may improve antiretroviral adherence among patients with bipolar disorder and HIV infection.

Research paper thumbnail of Clinical and Organizational Correlates of Medication for Youths in U.S. Mental Health Services

Soc Serv Rev, 2005

Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears... more Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission.

Research paper thumbnail of Access to Psychosocial Services Prior to Starting Antipsychotic Treatment Among Medicaid-Insured Youth

Journal of the American Academy of Child & Adolescent Psychiatry, 2015

To examine rates and predictors of receiving a psychosocial service before initiating antipsychot... more To examine rates and predictors of receiving a psychosocial service before initiating antipsychotic treatment among young people in the Medicaid program. A retrospective new-user cohort study of 8 state Medicaid programs focused on children and adolescents 0 to 20 years, initiating antipsychotic treatment (N = 24,372). The proportion receiving a psychosocial service in the 3 months before initiating antipsychotic treatment was calculated and stratified by socio-demographic and diagnostic characteristics arranged in 9 hierarchical groups, as follows: developmental, psychotic/bipolar, disruptive, attention-deficit/hyperactivity, obsessive-compulsive, stress, major depressive, anxiety, and other disorders. Less than one-half of youth received a psychosocial service before initiating antipsychotic treatment (48.8%). Compared to younger adolescents (12-17 years) initiating antipsychotic treatment (51.5%), corresponding younger children (0-5 years; 39.2%) and older adolescents (18-20 years; 40.1%), but not older children (6-11 years; 51.5%), were significantly less likely to have received a psychosocial service. In relation to youth diagnosed with psychotic or bipolar disorder (52.7%), those diagnosed with attention-deficit/hyperactivity (43.3%), developmental (41.4%), depressive (46.5%), or anxiety (35.6%) disorder were significantly less likely to have received a psychosocial service during the 3 months before antipsychotic initiation. By contrast, youth diagnosed with stress disorders (61.2%) were significantly more likely than those diagnosed with psychotic or bipolar disorders (52.7%) to have received a psychosocial service before starting an antipsychotic. A majority of Medicaid-insured youth initiating antipsychotic treatment have not received a psychosocial service in the preceding 3 months. This service pattern highlights a critical gap in access to psychosocial services.

Research paper thumbnail of How does HIV status affect rates of psychotropic use by Medicaid patients with schizophrenia?

Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices ... more Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices for Medicaid patients diagnosed with schizophrenia (SZ). Methods: Naturalistic observational study using Medicaid Analytic Extract files for 1999-2000 from California, Florida, New Jersey, and New York. Diagnostic classification based on International Classification of Disease 9–Clinical Modification. Inclusion criteria: Patients> 17 years old with one inpatient or two outpatient claims for SZ (295. x), and a minimum of one full year ...

Research paper thumbnail of Construction and validation of the Gender Attitude Inventory, a structured inventory to assess multiple dimensions of gender attitudes

Research paper thumbnail of Best Practices: MEDNET: A Multistate Policy Maker-Researcher Collaboration to Improve Prescribing Practices

Psychiatric services (Washington, D.C.), 2014

States face new federal requirements to monitor psychotropic prescribing practices for children a... more States face new federal requirements to monitor psychotropic prescribing practices for children and adults enrolled in Medicaid. Effective use of quality measurement and quality improvement strategies hold the promise of improved outcomes for public mental health systems. The Medicaid/Mental Health Network for Evidence-Based Treatment (MEDNET), funded by the Agency for Healthcare Research and Quality, is a multistate Medicaid quality collaborative with the Rutgers University Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes. This column describes the development, infrastructure, challenges, and early evidence of success of this public-academic partnership, the first multistate Medicaid quality improvement collaborative to focus on psychotropic medications.

Research paper thumbnail of Gender Attitude Inventory

Research paper thumbnail of Clinical and Organizational Correlates of Medication for Youths in U.S. Mental Health Services

Social Service Review, 2005

Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears... more Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission.

Research paper thumbnail of Bipolar Medication Use and Adherence to Antiretroviral Therapy Among Patients With HIV-AIDS and Bipolar Disorder

Psychiatric Services, 2011

The study examined relationships between adherence to bipolar medication and to antiretroviral th... more The study examined relationships between adherence to bipolar medication and to antiretroviral therapy, measured by medication fills, among patients with diagnoses of bipolar disorder and HIV infection. A retrospective study was conducted of Medicaid claims data (2001-2004) from eight states, focusing on antiretroviral adherence. The unit of analysis was person-month (N=53,971). The average observation period for the 1,687 patients was 32 months. Analyses controlled for several patient characteristics. Patients possessed antiretroviral drugs in 72% of the person-months. When a bipolar medication prescription was filled in the prior month, the rate of antiretroviral possession in the subsequent month was 78%, compared with 65% when bipolar medication was not filled in the prior month (p<.001). Odds of antiretroviral possession were 66% higher in months when patients had a prior-month supply of bipolar medication. Bipolar medication adherence may improve antiretroviral adherence among patients with bipolar disorder and HIV infection.

Research paper thumbnail of Navigating the Disability Process: Persons with Mental Disorders Applying for and Receiving Disability Benefits

Research paper thumbnail of Studying Prescription Drug Use and Outcomes With Medicaid Claims Data

Medical Care, 2007

Medicaid claims and eligibility data, particularly when linked to other sources of patient-level ... more Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss "best practices" for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information.

Research paper thumbnail of Prevalence and Treatment of Diagnosed Depression among Elderly Nursing Home Residents in Ohio

Journal of the American Medical Directors Association, 2007

Objectives-To examine the prevalence and treatment of diagnosed depression among elderly nursing ... more Objectives-To examine the prevalence and treatment of diagnosed depression among elderly nursing home residents and determine the resident and facility characteristics associated with diagnosis and treatment.

Research paper thumbnail of Psychiatric Diagnosis and Antiretroviral Adherence Among Adolescent Medicaid Beneficiaries Diagnosed With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

The Journal of Nervous and Mental Disease, 2009

Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS... more Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has suggested that psychiatric and substance abuse comorbidities are prevalent in this population, and that these may sometimes be associated with use of antiretroviral therapy (ART) and adherence. For adolescents with HIV/AIDS, much less is known about patterns of mental health comorbidity, and even fewer data are available that compare them to socioeconomically comparable youth without HIV/AIDS. Using medical and pharmacy data from 1999 to 2000 Medicaid claims (Medicaid Analytic Extract) from 4 states for beneficiaries aged 12 to 17 years, we identified 833 youth under care for HIV/AIDS meeting study criteria within the HIV/AIDS group, receipt of ART was less likely for youth who had diagnoses of substance abuse, conduct disorders, or emotional disorders than for others. Once ART was initiated, adherence did not significantly differ between adolescents living with a psychiatric condition, and those who were not, with the exception of an association between conduct disorder and lower adherence. Among those with HIV/AIDS, ART use and adherence were more common among youth with higher rates of service use, regardless of psychiatric status. Associations between race and adherence varied by gender: compared with their white counterparts, minority girls had lower, and minority boys had higher adherence.

Research paper thumbnail of US Patterns of Mental Health Service Utilization for Transition-Age Youth and Young Adults

The Journal of Behavioral Health Services & Research, 2008

This study examines rates of admission and patterns of mental health service use by persons of tr... more This study examines rates of admission and patterns of mental health service use by persons of transition age (16-25 years) in the USA based on the nationally representative 1997 Client/Patient Sample Survey and population data from the US Census Bureau. A precipitous decline in utilization was observed at the age of emancipation: the yearly admission rate for inpatient, outpatient, and residential services was 34 per 1,000 for 16-and 17-year-olds and 18 per 1,000 for 18-and 19-year-olds. Among 20-and 21-year-olds, more were referred from criminal justice and fewer from family or friends and social services, and proportionately more were Medicaid Results from preliminary analyses were presented at

Research paper thumbnail of Treatment Of People With Mental Illness: A Decade-Long Perspective

Research paper thumbnail of Employing Persons With Serious Mental Illness

Health Affairs, 2002

Health Affairs by content.healthaffairs.org Downloaded from 2 4 2 S e p t e m b e r / O c t o b e... more Health Affairs by content.healthaffairs.org Downloaded from 2 4 2 S e p t e m b e r / O c t o b e r 2 0 0 2 D a t a W a t c h

Research paper thumbnail of Disparities in consistent use of antiretroviral medication among Medicaid beneficiaries with HIV/AIDS in the US: Results of a multivariate analysis

Annual Meeting

Background: Several studies have documented racial/ethnic disparities in HIV/AIDS outcomes. Subop... more Background: Several studies have documented racial/ethnic disparities in HIV/AIDS outcomes. Suboptimal and disparate outcomes may arise if patients do not consistently remain on regimens over time. Therefore, it is important to examine treatment consistency over time, within broad, generalizable populations. Methods: We used 2000 data on Medicaid beneficiaries in four states accounting for more than 40% of US AIDS cases, measuring proportion of observation time covered by a filled prescription for PI/NNRTI ...

Research paper thumbnail of How does HIV status affect rates of psychotropic use by Medicaid patients with schizophrenia?

Annual Meeting, Nov 5, 2007

Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices ... more Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices for Medicaid patients diagnosed with schizophrenia (SZ). Methods: Naturalistic observational study using Medicaid Analytic Extract files for 1999-2000 from California, Florida, New Jersey, and New York. Diagnostic classification based on International Classification of Disease 9–Clinical Modification. Inclusion criteria: Patients> 17 years old with one inpatient or two outpatient claims for SZ (295. x), and a minimum of one full year ...

Research paper thumbnail of Best Practices: MEDNET: A Multistate Policy Maker-Researcher Collaboration to Improve Prescribing Practices

Psychiatric Services, Jan 11, 2014

States face new federal requirements to monitor psychotropic prescribing practices for children a... more States face new federal requirements to monitor psychotropic prescribing practices for children and adults enrolled in Medicaid. Effective use of quality measurement and quality improvement strategies hold the promise of improved outcomes for public mental health systems. The Medicaid/Mental Health Network for Evidence-Based Treatment (MEDNET), funded by the Agency for Healthcare Research and Quality, is a multistate Medicaid quality collaborative with the Rutgers University Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes. This column describes the development, infrastructure, challenges, and early evidence of success of this public-academic partnership, the first multistate Medicaid quality improvement collaborative to focus on psychotropic medications.

Research paper thumbnail of US Patterns of Mental Health Service Utilization for Transition-Age Youth and Young Adults

This study examines rates of admission and patterns of mental health service use by persons of tr... more This study examines rates of admission and patterns of mental health service use by persons of transition age (16-25 years) in the USA based on the nationally representative 1997 Client/Patient Sample Survey and population data from the US Census Bureau. A precipitous decline in utilization was observed at the age of emancipation: the yearly admission rate for inpatient, outpatient, and residential services was 34 per 1,000 for 16-and 17-year-olds and 18 per 1,000 for 18-and 19-year-olds. Among 20-and 21-year-olds, more were referred from criminal justice and fewer from family or friends and social services, and proportionately more were Medicaid Results from preliminary analyses were presented at

Research paper thumbnail of Bipolar Medication Use and Adherence to Antiretroviral Therapy Among Patients With HIV-AIDS and Bipolar Disorder

Psychiatric Services, 2011

The study examined relationships between adherence to bipolar medication and to antiretroviral th... more The study examined relationships between adherence to bipolar medication and to antiretroviral therapy, measured by medication fills, among patients with diagnoses of bipolar disorder and HIV infection. A retrospective study was conducted of Medicaid claims data (2001-2004) from eight states, focusing on antiretroviral adherence. The unit of analysis was person-month (N=53,971). The average observation period for the 1,687 patients was 32 months. Analyses controlled for several patient characteristics. Patients possessed antiretroviral drugs in 72% of the person-months. When a bipolar medication prescription was filled in the prior month, the rate of antiretroviral possession in the subsequent month was 78%, compared with 65% when bipolar medication was not filled in the prior month (p<.001). Odds of antiretroviral possession were 66% higher in months when patients had a prior-month supply of bipolar medication. Bipolar medication adherence may improve antiretroviral adherence among patients with bipolar disorder and HIV infection.

Research paper thumbnail of Clinical and Organizational Correlates of Medication for Youths in U.S. Mental Health Services

Soc Serv Rev, 2005

Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears... more Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission.

Research paper thumbnail of Access to Psychosocial Services Prior to Starting Antipsychotic Treatment Among Medicaid-Insured Youth

Journal of the American Academy of Child & Adolescent Psychiatry, 2015

To examine rates and predictors of receiving a psychosocial service before initiating antipsychot... more To examine rates and predictors of receiving a psychosocial service before initiating antipsychotic treatment among young people in the Medicaid program. A retrospective new-user cohort study of 8 state Medicaid programs focused on children and adolescents 0 to 20 years, initiating antipsychotic treatment (N = 24,372). The proportion receiving a psychosocial service in the 3 months before initiating antipsychotic treatment was calculated and stratified by socio-demographic and diagnostic characteristics arranged in 9 hierarchical groups, as follows: developmental, psychotic/bipolar, disruptive, attention-deficit/hyperactivity, obsessive-compulsive, stress, major depressive, anxiety, and other disorders. Less than one-half of youth received a psychosocial service before initiating antipsychotic treatment (48.8%). Compared to younger adolescents (12-17 years) initiating antipsychotic treatment (51.5%), corresponding younger children (0-5 years; 39.2%) and older adolescents (18-20 years; 40.1%), but not older children (6-11 years; 51.5%), were significantly less likely to have received a psychosocial service. In relation to youth diagnosed with psychotic or bipolar disorder (52.7%), those diagnosed with attention-deficit/hyperactivity (43.3%), developmental (41.4%), depressive (46.5%), or anxiety (35.6%) disorder were significantly less likely to have received a psychosocial service during the 3 months before antipsychotic initiation. By contrast, youth diagnosed with stress disorders (61.2%) were significantly more likely than those diagnosed with psychotic or bipolar disorders (52.7%) to have received a psychosocial service before starting an antipsychotic. A majority of Medicaid-insured youth initiating antipsychotic treatment have not received a psychosocial service in the preceding 3 months. This service pattern highlights a critical gap in access to psychosocial services.

Research paper thumbnail of How does HIV status affect rates of psychotropic use by Medicaid patients with schizophrenia?

Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices ... more Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices for Medicaid patients diagnosed with schizophrenia (SZ). Methods: Naturalistic observational study using Medicaid Analytic Extract files for 1999-2000 from California, Florida, New Jersey, and New York. Diagnostic classification based on International Classification of Disease 9–Clinical Modification. Inclusion criteria: Patients> 17 years old with one inpatient or two outpatient claims for SZ (295. x), and a minimum of one full year ...

Research paper thumbnail of Construction and validation of the Gender Attitude Inventory, a structured inventory to assess multiple dimensions of gender attitudes

Research paper thumbnail of Best Practices: MEDNET: A Multistate Policy Maker-Researcher Collaboration to Improve Prescribing Practices

Psychiatric services (Washington, D.C.), 2014

States face new federal requirements to monitor psychotropic prescribing practices for children a... more States face new federal requirements to monitor psychotropic prescribing practices for children and adults enrolled in Medicaid. Effective use of quality measurement and quality improvement strategies hold the promise of improved outcomes for public mental health systems. The Medicaid/Mental Health Network for Evidence-Based Treatment (MEDNET), funded by the Agency for Healthcare Research and Quality, is a multistate Medicaid quality collaborative with the Rutgers University Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes. This column describes the development, infrastructure, challenges, and early evidence of success of this public-academic partnership, the first multistate Medicaid quality improvement collaborative to focus on psychotropic medications.

Research paper thumbnail of Gender Attitude Inventory

Research paper thumbnail of Clinical and Organizational Correlates of Medication for Youths in U.S. Mental Health Services

Social Service Review, 2005

Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears... more Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission.

Research paper thumbnail of Bipolar Medication Use and Adherence to Antiretroviral Therapy Among Patients With HIV-AIDS and Bipolar Disorder

Psychiatric Services, 2011

The study examined relationships between adherence to bipolar medication and to antiretroviral th... more The study examined relationships between adherence to bipolar medication and to antiretroviral therapy, measured by medication fills, among patients with diagnoses of bipolar disorder and HIV infection. A retrospective study was conducted of Medicaid claims data (2001-2004) from eight states, focusing on antiretroviral adherence. The unit of analysis was person-month (N=53,971). The average observation period for the 1,687 patients was 32 months. Analyses controlled for several patient characteristics. Patients possessed antiretroviral drugs in 72% of the person-months. When a bipolar medication prescription was filled in the prior month, the rate of antiretroviral possession in the subsequent month was 78%, compared with 65% when bipolar medication was not filled in the prior month (p<.001). Odds of antiretroviral possession were 66% higher in months when patients had a prior-month supply of bipolar medication. Bipolar medication adherence may improve antiretroviral adherence among patients with bipolar disorder and HIV infection.

Research paper thumbnail of Navigating the Disability Process: Persons with Mental Disorders Applying for and Receiving Disability Benefits

Research paper thumbnail of Studying Prescription Drug Use and Outcomes With Medicaid Claims Data

Medical Care, 2007

Medicaid claims and eligibility data, particularly when linked to other sources of patient-level ... more Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss "best practices" for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information.

Research paper thumbnail of Prevalence and Treatment of Diagnosed Depression among Elderly Nursing Home Residents in Ohio

Journal of the American Medical Directors Association, 2007

Objectives-To examine the prevalence and treatment of diagnosed depression among elderly nursing ... more Objectives-To examine the prevalence and treatment of diagnosed depression among elderly nursing home residents and determine the resident and facility characteristics associated with diagnosis and treatment.

Research paper thumbnail of Psychiatric Diagnosis and Antiretroviral Adherence Among Adolescent Medicaid Beneficiaries Diagnosed With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

The Journal of Nervous and Mental Disease, 2009

Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS... more Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has suggested that psychiatric and substance abuse comorbidities are prevalent in this population, and that these may sometimes be associated with use of antiretroviral therapy (ART) and adherence. For adolescents with HIV/AIDS, much less is known about patterns of mental health comorbidity, and even fewer data are available that compare them to socioeconomically comparable youth without HIV/AIDS. Using medical and pharmacy data from 1999 to 2000 Medicaid claims (Medicaid Analytic Extract) from 4 states for beneficiaries aged 12 to 17 years, we identified 833 youth under care for HIV/AIDS meeting study criteria within the HIV/AIDS group, receipt of ART was less likely for youth who had diagnoses of substance abuse, conduct disorders, or emotional disorders than for others. Once ART was initiated, adherence did not significantly differ between adolescents living with a psychiatric condition, and those who were not, with the exception of an association between conduct disorder and lower adherence. Among those with HIV/AIDS, ART use and adherence were more common among youth with higher rates of service use, regardless of psychiatric status. Associations between race and adherence varied by gender: compared with their white counterparts, minority girls had lower, and minority boys had higher adherence.

Research paper thumbnail of US Patterns of Mental Health Service Utilization for Transition-Age Youth and Young Adults

The Journal of Behavioral Health Services & Research, 2008

This study examines rates of admission and patterns of mental health service use by persons of tr... more This study examines rates of admission and patterns of mental health service use by persons of transition age (16-25 years) in the USA based on the nationally representative 1997 Client/Patient Sample Survey and population data from the US Census Bureau. A precipitous decline in utilization was observed at the age of emancipation: the yearly admission rate for inpatient, outpatient, and residential services was 34 per 1,000 for 16-and 17-year-olds and 18 per 1,000 for 18-and 19-year-olds. Among 20-and 21-year-olds, more were referred from criminal justice and fewer from family or friends and social services, and proportionately more were Medicaid Results from preliminary analyses were presented at

Research paper thumbnail of Treatment Of People With Mental Illness: A Decade-Long Perspective

Research paper thumbnail of Employing Persons With Serious Mental Illness

Health Affairs, 2002

Health Affairs by content.healthaffairs.org Downloaded from 2 4 2 S e p t e m b e r / O c t o b e... more Health Affairs by content.healthaffairs.org Downloaded from 2 4 2 S e p t e m b e r / O c t o b e r 2 0 0 2 D a t a W a t c h

Research paper thumbnail of Disparities in consistent use of antiretroviral medication among Medicaid beneficiaries with HIV/AIDS in the US: Results of a multivariate analysis

Annual Meeting

Background: Several studies have documented racial/ethnic disparities in HIV/AIDS outcomes. Subop... more Background: Several studies have documented racial/ethnic disparities in HIV/AIDS outcomes. Suboptimal and disparate outcomes may arise if patients do not consistently remain on regimens over time. Therefore, it is important to examine treatment consistency over time, within broad, generalizable populations. Methods: We used 2000 data on Medicaid beneficiaries in four states accounting for more than 40% of US AIDS cases, measuring proportion of observation time covered by a filled prescription for PI/NNRTI ...

Research paper thumbnail of How does HIV status affect rates of psychotropic use by Medicaid patients with schizophrenia?

Annual Meeting, Nov 5, 2007

Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices ... more Objectives: To investigate the impact of co-occurring HIV on psychotropic prescription practices for Medicaid patients diagnosed with schizophrenia (SZ). Methods: Naturalistic observational study using Medicaid Analytic Extract files for 1999-2000 from California, Florida, New Jersey, and New York. Diagnostic classification based on International Classification of Disease 9–Clinical Modification. Inclusion criteria: Patients> 17 years old with one inpatient or two outpatient claims for SZ (295. x), and a minimum of one full year ...