Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York, Albany, NY 12222, USA.
Am J Public Health. 2011 Jun;101(6):1103-9. doi: 10.2105/AJPH.2010.300100. Epub 2011 Apr 14.
We sought state-level factors associated with the adoption of medications to treat mental health conditions on state formularies for the AIDS Drug Assistance Program.
We interviewed 22 state and national program experts and identified 7 state-level factors: case burden, federal dollar-per-case Ryan White allocation size, political orientation, state wealth, passage of a mental health parity law, number of psychiatrists per population, and size of mental health budget. We then used survival analysis to test whether the factors were associated with faster adoption of psychotropic drugs from 1997 to 2008.
The relative size of a state's federal Ryan White HIV/AIDS Program allocation, the state's political orientation, and its concentration of psychiatrists were significantly associated with time-to-adoption of psychotropic drugs on state AIDS Drug Assistance Program formularies.
Substantial heterogeneity exists across states in formulary adoption of drugs to treat mental illness. Understanding what factors contribute to variation in adoption is vital given the importance of treating mental health conditions as a component of comprehensive HIV care.
我们旨在研究与在艾滋病药物援助计划（AIDS Drug Assistance Program）州级处方中采用治疗精神健康状况的药物相关的州级因素。
我们采访了 22 名州和国家项目专家，并确定了 7 个州级因素：病例负担、每例联邦资金分配规模、政治取向、州富裕程度、通过精神健康平等法、每人口精神科医生数量和精神健康预算规模。然后，我们使用生存分析来检验这些因素是否与从 1997 年到 2008 年更快地采用精神药物有关。
一个州的联邦 Ryan White HIV/AIDS 计划分配的相对规模、该州的政治取向以及其精神科医生的集中程度与在州艾滋病药物援助计划处方中采用精神药物的时间显著相关。
在治疗精神疾病的药物处方采用方面，各州之间存在着显著的异质性。了解哪些因素导致采用的差异对于将精神健康状况作为综合 HIV 护理的一个组成部分非常重要。
