Cardiovascular drug utilisation and socio-economic inequalities in 20 districts of the Czech Republic.
OBJECTIVE
To analyse whether there exists a socio-economic gradient in utilisation of cardiovascular drugs at the district level in the Czech Republic.


METHODS
The aggregated data on drug utilisation during the period 1997-2000, expressed in defined daily doses per 1000 inhabitants per day, were obtained from the General Health Insurance Company. Socio-economic characteristics of the districts in year 2000 (percentage of university-educated inhabitants, percentage of single-member households, number of ambulatory physicians per 10,000 inhabitants, unemployment rate and mean monthly income) were used as single unadjusted predictor variables. Partial correlation controlling for age in districts was used to analyse the relationship of cardiovascular disease (CVD) drug utilisation and several socio-economic variables.


RESULTS
There were considerable differences in the utilisation of CVD drugs within the districts studied. Significantly higher utilisation of dihydropyridine Ca-channel blockers and statins was found in the districts with a higher percentage of university-educated inhabitants and more ambulatory physicians. CVD drug utilisation (nitrates, fibrates, selective beta-blockers, verapamil and diltiazem and statins) correlated significantly with the percentage of single-member households. The five socio-economic variables explained more than 60% of the variability in use of dihydropyridine Ca-channel blockers, verapamil and diltiazem, ACE inhibitors and statins.


CONCLUSIONS
There exists a significant gradient in the utilisation of mainly newer CVD drug groups within districts of the Czech Republic that can be, at least partly, explained by social characteristics of the districts.
Gorecka
Kvetoslava
K
Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 02 Hradec Kralove, Czech Republic. goreckak@faf.cuni.cz
Linhartova
Alena
A
Vlcek
Jiri
J
Tilser
Ivan
I
D002317:Cardiovascular Agents / Q000191:economics* / Q000627:therapeutic use; D018153:Czech Republic; D004363:Drug Utilization / Q000191:economics*; D004522:Educational Status; D004651:Employment; D005191:Family Characteristics; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D012959:Socioeconomic Factors
D002317:Cardiovascular Agents