title: Children in need of Pharmacare: medication funding requests at the Toronto Hospital for Sick Children.
abstract: OBJECTIVE
  Although a national Pharmacare program ensuring access to and affordability of needed medications has repeatedly been cited as a priority to policymakers, 20% of families remain either uninsured or under-insured. The Hospital for Sick Children's Patient Amenities Fund (PAF) covers out-of-pocket medication expenses for inpatient and outpatient children. The research objectives were to 1) examine family demographics and socio-economic status (SES), the types of medications requested and government program process issues of PAF applicants in 1998 and 1999, and 2) describe trends in PAF requests from 1998 to 2000.
  
  
  METHODS
  Data were extracted retrospectively from fund requests, charts and social work and discharge planning reports. Descriptive statistics were used to summarize the data and to examine time trends.
  
  
  RESULTS
  Eighty-six applicants submitted 112 requests from 1998-1999. Most were for children with cancer, neurological disorders and transplant patients. Medication expenditures were 22,408 dollars in 1999, a 39% increase over 1998. Most requests came from two-parent nuclear families where one or both parents were employed. High deductibles, waiting time, application form complexity and request denials were cited as problems encountered with government drug plans.
  
  
  CONCLUSIONS
  The findings suggest that for provinces that do not provide universal drug insurance programs, relying on a patchwork of government plans and community agencies may not be effective in ensuring easy and timely access to necessary medications for children.
authors.affiliation: Division of Population Health Sciences, Hospital for Sick Children, Toronto, ON. wendy.ungar@sickkids.ca
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: Carolyn
authors.initials: C
authors.lastname: Daniels
authors.forename: Ted
authors.initials: T
authors.lastname: McNeill
authors.forename: Mahdie
authors.initials: M
authors.lastname: Seyed
mesh_terms: D002648:Child; D005381:Financing, Organized; D006297:Health Services Accessibility / Q000191:economics*; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006776:Hospitals, Pediatric / Q000191:economics*; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008483:Medical Assistance; D017057:Medically Uninsured; D009313:National Health Programs; D009864:Ontario; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D015397:Program Evaluation; D017150:Public Sector; D012189:Retrospective Studies; D012923:Social Class