Semester

Spring

Date of Graduation

2006

Document Type

Thesis

Degree Type

MS

College

School of Pharmacy

Department

Pharmaceutical Systems and Policy

Committee Chair

S. Suresh Madhavan.

Abstract

Prescription drug payments are the fastest growing and most widely varying expenditures across state Medicaid programs. To aid health policy efforts, this study identified determinants of drug utilization and expenditures using Andersen's Behavior Model of Health Services Utilization. A Structure Equation Model was built using five-year data for 48 states, to test relationships among the latent constructs of policy, access, predisposing characteristics, enabling resources, and need for healthcare; and, their influence on drug utilization. Only predisposing characteristics and enabling resources showed significant effects on drug utilization. Cluster Analysis classified state Medicaid programs into eight groups that differ on federal matching, prior authorization, federal support, access to physicians, high school graduation rate, and disease severity. Finally, panel data regression methods offered a predictive model for estimating changes in per capita drug expenditure using time-adjusted pure effects of federal matching, access to physicians, disease severity, unemployment, and high school graduation rates.

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