Cuellar Alison Evans, Kelleher Kelly J, Kataoka Sheryl, Adelsheim Steven, Cocozza Joseph J
Department of Health Policy and Management, Columbia University, 600 W 168th St, Sixth Floor, New York, NY 10032, USA.
Arch Pediatr Adolesc Med. 2008 Mar;162(3):219-24. doi: 10.1001/archpediatrics.2007.47.
To determine changes in psychotropic medication use before and after juvenile justice incarceration, contrasting stays in long-stay commitment facilities and short-stay detention facilities.
Statewide administrative data (July 1, 1998, through June 30, 2003) from the Florida Department of Juvenile Justice and Florida Medicaid. Medication prescriptions filled before entry and after release from facilities were determined based on paid claims. Psychotropic medication was categorized by drug class based on the National Drug Code.
General community services.
All of the Medicaid-enrolled youth aged 11 to 17 years identified as having a stay in a juvenile justice facility. The total sample included 67 819 detention stays and 59 918 commitment stays. Main Exposure Incarceration in juvenile commitment and detention facilities. Main Outcome Measure Filled prescriptions for psychotropic medication by class 30 and 90 days before and after incarceration.
Ninety days prior to detention, 3666 youth (5.4%) had psychotropic drug claims. Among these, 2296 (62.6%) had any psychotropic medication claims in the 30 days after release. Among commitment cases, 29.6% continued medication use after release. Onset of medication use after release from detention and commitment facilities was relatively uncommon (1.7% and 1.9%, respectively). Youth in commitment facilities were less likely than youth in detention facilities to resume their medication use across drug classes after 30 days (chi(2)(3) = 6.28; P = .04) and after 90 days (chi(2)(2) = 7.62; P = .02).
The results find greater support for a disruption effect than a discovery effect from incarceration. The findings suggest several areas for further investigation and improvement of services for incarcerated youth.
确定青少年司法监禁前后精神药物使用情况的变化，对比长期收容设施和短期拘留设施中的情况。
来自佛罗里达州青少年司法部和佛罗里达医疗补助计划的全州行政数据（1998年7月1日至2003年6月30日）。根据已支付的索赔确定入院前和出院后所开具的药物处方。精神药物根据国家药品代码按药物类别分类。
一般社区服务机构。
所有被确定曾入住青少年司法设施的11至17岁医疗补助计划参保青年。总样本包括67819次拘留和59918次收容。主要暴露因素青少年收容和拘留设施中的监禁。主要结局指标监禁前后30天和90天按类别开具的精神药物处方。
在拘留前90天，3666名青年（5.4%）有精神药物索赔。其中，2296名（62.6%）在释放后的30天内有任何精神药物索赔。在收容案例中，29.6%的人在释放后继续使用药物。从拘留和收容设施释放后开始使用药物的情况相对不常见（分别为1.7%和1.9%）。在30天后（χ²(3)=6.28；P=.04）和90天后（χ²(2)=7.62；P=.02），收容设施中的青年比拘留设施中的青年在各类药物上恢复用药的可能性更小。
结果发现监禁的干扰效应比发现效应得到了更多支持。研究结果表明了几个需要进一步调查和改善被监禁青年服务的领域。
