(HealthDay News) — Regional variation exceeds payer-related differences in prescription use among children, according to a study published online August 11 in Pediatrics.

Shelsey J. Weinstein, from the Geisel School of Medicine at Dartmouth in Hanover, NH, and colleagues quantified overall and drug group-specific prescription use among 949,821 children aged 0–17 years. Northern New England all-payer administrative data (2007–2010) enabled the evaluation of prescription use by payer type and within payer type across 69 hospital service areas (HSAs).

The researchers found the 54% of children were covered by Medicaid and 46% by commercial payers. Mean annual prescriptions were 3.4 per person-year for commercial patients and 5.5 for Medicaid patients. Payer type differences were smaller than HSA-level variation within payer type. There were two-fold variations in HSA-level rates of attention-deficit/hyperactivity disorder drug use (fifth to 95th percentile) in Medicaid patients and more than two-fold variation in commercially-insured children. Similarly, within each payer type, HSA-level antidepressant use varied more than two-fold. The variation was three-fold for antacid use across HSAs and was highest in infants where commercial use exceeded Medicaid use.

“Efforts should advance best pediatric prescribing discussions and shared decision-making,” the authors write.

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