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Anita L. Kozyrskyj, PhD; Cameron A. Mustard, ScD; F. Estelle R. Simons, MD

Arch Pediatr Adolesc Med. 2001;155:1219-1224.

Background  Low-income children with asthma are less likely to receive inhaled corticosteroid prescriptions that can prevent asthma morbidity.

Objective  To determine whether the receipt of inhaled corticosteroids in children with asthma is related to household socioeconomic status and type of drug insurance.

Design  Using population-based prescription and health care data from Manitoba, a cohort study of the determinants of receiving new prescriptions for inhaled corticosteroids was conducted in children treated with asthma drugs.

Participants  School-aged children (n = 12 481) receiving asthma prescriptions from January 1995 to March 1996 but no inhaled corticosteroid prescriptions in the initial 6-month period.

Main Outcome Measures  Household socioeconomic and drug insurance predictors of the probability of receiving a new inhaled corticosteroid prescription from July 1995 to March 1998, following adjustment for disease and health care utilization factors.

Results  In comparison with higher-income children insured through a provincial cost-sharing drug plan, the adjusted likelihood ratio for a new inhaled corticosteroid prescription was 0.88 (95% confidence interval, 0.80-0.97) in low-income children insured through the same drug plan and 0.82 (95% confidence interval, 0.76-0.88) in children receiving prescriptions at no charge through provincial income assistance or First Nations benefits programs (Winnipeg, Manitoba).

Conclusion  Independent of asthma severity, type of drug insurance, or health care utilization patterns, low-income children with asthma are significantly less likely to receive inhaled corticosteroid prescriptions.

From the Department of Community Health Sciences, Manitoba Centre for Health Policy and Evaluation (Dr Kozyrskyj), Winnipeg; the Department of Public Health Sciences, University of Toronto (Dr Mustard), Toronto, Ontario; and the Department of Pediatrics and Child Health, University of Manitoba (Dr Simons), Winnipeg.

Corresponding author and reprints: Anita L. Kozyrskyj, PhD, Department of Community Health Sciences, Manitoba Centre for Health Policy and Evaluation, Faculty of Medicine, University of Manitoba, S101-750 Bannatyne Ave, Winnipeg, Manitoba R3E 0W3 (e-mail: kozyrsk{at}cc.umanitoba.ca).

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