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Prevalence and Treatment Utilization of Patients Diagnosed with Depression and Anxiety Disorders Based on Kentucky Medicaid 2012-2019 Datasets

Yuchen Han1, Haojiang Huang2, Riten Mitra1, Huirong Hu1, Subhadip Pal1, Craig McClain3,4,5, K.B. Kulasekera1, Maiying Kong1,5*

Objectives: To examine the prevalence and treatment utilization of patients diagnosed with Depression and Anxiety Disorders (DAD) based on Kentucky Medicaid 2012-2019 datasets.

Methods: The study was based on Kentucky Medicaid claims data from 2012 through 2019 for patients 14 years and older. We constructed yearly patient-level databases using ICD-9 CM and ICD-10 CM codes to identify the patients with DAD; the Current Procedure Terminology (CPT) codes to identify individual psychotherapy and group psychotherapy; and the National drug codes to categorize pharmacotherapy. Based on these data, we constructed summary tables that reflected the trends in prevalence of DAD across eight Kentucky Medicaid regions and for different demographic subgroups. Next, we implemented logistic regression on the constructed yearly patient-level data spanning all 8 years to formally assess the impact of risk factors and treatments on the occurrence of DAD. The potential risk factors included age, gender, race/ethnicity, geographic characteristics, comorbidities of alcohol use disorder and tobacco use.

Results: The prevalence of DAD increased from 30.84% in 2012 to 36.04% in 2019. The prevalence of DAD was significantly higher in patients with the following characteristics: non-Hispanic white, females, aged between 45 and 54 years old, living in rural areas, having alcohol use disorder, and using tobaccos. Other than 2013, the utilization of pharmacotherapy maintained at about 62%. The utilization of psychotherapy increased over years from 24.4% in 2012 to 36.5% in 2019. Overall, utilization of any treatment slightly increased from 70.9% in 2012 to 73.3% in 2019 except a drastic decline in 2013 due to the reduction of Benzodiazepine prescription. Patients being whites, females, and living in rural areas were more likely to use pharmacotherapy, and patients living in rural areas were less likely to use psychotherapy than those residing in metro areas.

Conclusion: The prevalence of DAD has increased over time from 2012 to 2019. The utilization of pharmacotherapy maintained at 62% over eight years except 2013, and the utilization of psychotherapy has steadily increased over time.