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Polypharmacy & teen pregnancy findings 2017 05-23

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Key findings of research paper by HCMS and WY DFS on foster teen pregnancy and polypharmacy rates, being published in Child Welfare, journal of Child Welfare League of America.

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Polypharmacy & teen pregnancy findings 2017 05-23

  1. 1. 1HCMS Group | Copyright 2017, All Rights Reserved | Confidential Polypharmacy and Pregnancy Among Foster Children Research Paper Published by HCMS And Wyoming Department of Family Services
  2. 2. 2HCMS Group | Copyright 2017, All Rights Reserved | Confidential We know from working with many populations that taking multiple prescription drugs simultaneously – polypharmacy – is a factor in high risk to health. Polypharmacy and Risk to Health Population 95% 5% Cost 56% (Avg. Cost $32,000) 44% (Avg. Cost $800) 5% of This Population Drives 56% of Benefit Costs High-Risk 5% Low-Risk 95% $32,000 Annual Cost $800 10.0 Providers 1.5 11.0 Diagnoses 2.0 32.0 Tests 2.5 9.5 Medications 2.0 80% Short-Term Disability 5%
  3. 3. 3HCMS Group | Copyright 2017, All Rights Reserved | Confidential Study Group by Health Plan, With Childbirths by Age Group N Childbirth at 15 Childbirth at 16 Childbirth at 17 Childbirth at 18 Foster-Care Medicaid 743 24 29 58 106 Non-Foster Medicaid 2,636 39 71 144 206 Private Coverage 1,947 3 2 9 14 Total 5,326 66 102 211 326 Study of Pregnancy Among 3 Groups We followed more than 5,000 teenage girls for four years each in a study covering more than 11 years.
  4. 4. 4HCMS Group | Copyright 2017, All Rights Reserved | Confidential Much Higher Pregnancy Rates for Foster Teens 3.2% 3.9% 7.8% 14.3% 1.5% 2.7% 5.5% 7.8% 0.2% 0.1% 0.5% 0.7% 0% 2% 4% 6% 8% 10% 12% 14% 16% 15 16 17 18 PregnancyRate Age Pregnancy Rate by Age Medicaid - Foster Care Medicaid - Not Foster Care Wyoming Private Insurance
  5. 5. 5HCMS Group | Copyright 2017, All Rights Reserved | Confidential Much Higher Rates of Mental Health Diagnoses for Foster Teens 63.3% 63.3% 61.1% 46.6% 21.4% 24.2% 24.9% 23.4% 10.4% 13.5% 14.0% 11.0% 0% 10% 20% 30% 40% 50% 60% 70% 15 16 17 18 MentalDisorderRate Age Mental Health Diagnoses by Age Medicaid - Foster Care Medicaid - Not Foster Care Wyoming Private Insurance
  6. 6. 6HCMS Group | Copyright 2017, All Rights Reserved | Confidential Much Higher Psychotherapeutic Drug Rates for Foster Teens 47.5% 48.3% 42.8% 29.1% 15.4% 17.3% 18.6% 16.8% 6.7% 8.9% 10.5% 9.8% 0% 10% 20% 30% 40% 50% 60% 15 16 17 18 PsychotherapeuticRxRate Age Medicaid - Foster Care Medicaid - Not Foster Care Wyoming Private Insurance Psychotherapeutic Drug Prescription Rates by Age
  7. 7. 7HCMS Group | Copyright 2017, All Rights Reserved | Confidential Table 2: Number of Medications by Age and Sub-Group Age Medicaid - Foster Care Medicaid - Not Foster Care Wyoming Private Insurance N=743 N=2,636 N=1,947 Total Number of Meds Median No. of Meds Total Number of Meds Median No. of Meds Total Number of Meds Median No. of Meds 15 4,416 5 11,446 3 4,341 1 16 4,833 5 13,020 4 5,330 2 17 4,985 5 13,925 4 6,096 2 18 3,949 4 12,403 3 5,528 2 Polypharmacy Much More Prevalent Among Foster Teen Group
  8. 8. 8HCMS Group | Copyright 2017, All Rights Reserved | Confidential Strong Correlation Between Polypharmacy and Teen Pregnancy 9.4% 12.5% 16.4% 21.3% 0% 5% 10% 15% 20% 25% 5 Meds 10 Meds 15 Meds 20 Meds LikelihoodofaPregnancy Polypharmacy and Pregnancy Notes: The number of medications is for the year when each girl was age 15. The likelihood of pregnancy reflects childbirths at the ages of 16, 17, and 18. The polypharmacy variable (number of unique medications) was a statistically significant predictor of the likelihood of a pregnancy (p-value < 0.01).
  9. 9. 9HCMS Group | Copyright 2017, All Rights Reserved | Confidential Our findings add to evidence that polypharmacy intended to help manage troubled children can instead add a layer of abuse. The costs include Medicaid outlays for drugs, prenatal care, maternity – and more children the system must then cover. Recommendations  Prevent polypharmacy: Monitoring doctors as in Wyoming; tougher foster-care laws as in several states.  Use risk metrics: HCMS research has shown that using our person-centric, predictive risk score, the Human Capital Risk Index, can provide caregivers advance warning of increasing risk to health, including risk from polypharmacy. Conclusions & Recommendations

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