The Effects of Patient Characteristics on ADHD Diagnosis and Treatment: A Factorial Study of Family Physicians

BMC Family Practice, Vol. 11, No. 11, 2010

Posted: 10 Feb 2010

See all articles by Christopher P. Morley

Christopher P. Morley

SUNY Upstate Medical University, Department of Family Medicine

Date Written: February 8, 2010

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a costly and prevalent disorder in the U.S., especially among youth. However, significant disparities in diagnosis and treatment appear to be predicted by the race and insurance status of patients. Methods: This study employed a web-based factorial survey with four ADHD cases derived from an ADHD clinic, two diagnosed with ADHD in actual evaluation, and two not. Randomized measures included race and insurance status of the patients. Participants (N=187) included clinician members of regional and national practice-based research networks and the U.S. clinical membership of the Society of Teachers of Family Medicine. The main outcomes were decisions to 1) diagnose and 2) treat the cases, based upon the information presente. Outcomes were analyzed via binary logistic regression of the randomized factors and case indicators on diagnosis and treatment. Results: ADHD-positive cases were 8 times more likely to be diagnosed and 12 times more likely to be treated, and the male ADHD positive case was more likely to be diagnosed and treated than the female ADHD positive case. Uninsured cases were significantly more likely to be treated overall, but male cases that were uninsured were about half as likely to be diagnosed and treated with ADHD. Additionally, African-American race appears to increase the likelihood of medicinal treatment for ADHD and being both African-American and uninsured appears to cut the odds of medicinal treatment in half, but not significantly. Conclusions: Family physicians were competent at discerning between near-threshold ADHD-negative and ADHD positive cases. However, insurance status and race, as well as gender, appear to affect the likelihood of diagnosis and treatment for ADHD in Family Medicine settings.

Keywords: Race, Insurance Status, ADHD, Factorial Survey, Gender, Mental Health

Suggested Citation

Morley, Christopher P., The Effects of Patient Characteristics on ADHD Diagnosis and Treatment: A Factorial Study of Family Physicians (February 8, 2010). BMC Family Practice, Vol. 11, No. 11, 2010, Available at SSRN: https://ssrn.com/abstract=1550335

Christopher P. Morley (Contact Author)

SUNY Upstate Medical University, Department of Family Medicine ( email )

College of Health Professions
Department of Physical Therapy
Syracuse, NY 13210
United States

HOME PAGE: http://www.upstate.edu/fmed/research.php

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