Socioeconomic status, drug insurance benefits, and new prescriptions for inhaled corticosteroids in schoolchildren with asthma.
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.


METHODS
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.


METHODS
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.


METHODS
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).


CONCLUSIONS
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.
Kozyrskyj
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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, Canada. kozyrsk@cc.umanitoba.ca
Mustard
C A
CA
Simons
F E
FE
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy* / Q000191:economics; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008350:Manitoba; D010818:Practice Patterns, Physicians'; D012923:Social Class
D005938:Glucocorticoids