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Socioeconomic Status, Drug Insurance Benefits, and New Prescriptions for Inhaled Corticosteroids in Schoolchildren With Asthma
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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