Diffusion of new medication across different income groups under a universal health insurance program: an example involving newly enlisted nonsteroidal anti-inflammatory drugs for elderly osteoarthritis patients
Tóm tắt
The aim of this research was to determine whether socioeconomic status, as measured by income level, impacts on the diffusion to patients of newly reimbursed nonsteroidal anti-inflammatory drugs (NSAIDs) under the National Health Insurance program in Taiwan. We used income tax records to identify the income levels of 324 male and 551 female randomly sampled osteoarthritis patients aged over 60 years in 2000. The study period was 2 years (t
1 = April 2001–March 2002 and t
2 = April 2002–March 2003). Generalized estimating equation models were used to analyze the impact of income level on being prescribed one of the newly reimbursed NSAIDs. The impact of income level on being treated with the new drug was positive and significant for females (OR = 2.11, p < 0.01) but not for males. The interaction term between income groups and the time trend was insignificant. Other factors associated with being treated with the new drug include age, habit of health-care utilization, and residential characteristics. Diffusion of new drugs still depends on income level despite the presence of a universal national health insurance system in Taiwan.
Tài liệu tham khảo
Alter DA, Naylor CD, Austin P, Tu JV (1999) Effects of socioeconomic status on access to invasive cardiac procedures and on mortality after acute myocardial infarction. N Engl J Med 341(18):1359–1367
Andrulis DP (1998) Access to care is the centerpiece in the elimination of socioeconomic disparities in health. Ann Intern Med 129(5):412–416
Aronson JR, Johnson P, Lambert PJ (1994) Redistributive effect and unequal tax treatment. Econ J 104:262–270
Beier ME, Ackerman PL (2003) Determinants of health knowledge: an investigation of age, gender, abilities, personality, and interests. J Pers Soc Psychol 84(2):439–448
Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Munoz JA, Puyol JA, Lara M, Watkins KE, Yang H, McGlynn EA (2001) Health information on the Internet: accessibility, quality, and readability in English and Spanish. JAMA 285(20):2612–2621
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA (2000) Gender differences in the utilization of health care services. J Fam Pract 49(2):147–152
Brantlinger EA (1987) Making decisions about special education placement: do low-income parents have the information they need? J Learn Disabil 20(2):94–101
Britton A, Shipley M, Marmot M, Hemingway H (2004) Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study. BMJ 329:7461, 318
Buhmann B, Rainwater L, Schmaus G, Smeeding TM (1988) Equivalence scales, well-being, inequality, and poverty: sensitivity estimates across ten countries using the Luxembourg Income Study (LIS) database. Rev Income Wealth 34:115–142
Chen CY, Liu CY, Su WC, Huang SL, Lin KM (2007) Factors associated with the diagnosis of neurodevelopmental disorders: a population-based longitudinal study. Pediatrics 119(2):e435–e443
Chen CY, Liu CY, Su WC, Huang SL, Lin KM (2008) Urbanicity-related variation in help-seeking and services utilization among preschool-age children with autism in Taiwan. J Autism Dev Disord 38(3):489–497
Cheng TM (2003) Taiwan’s new national health insurance program: genesis and experience so far. Health Aff (Millwood) 22(3):61–76
Crystal S, Sambamoorthi U, Merzel C (1995) The diffusion of innovation in AIDS treatment: zidovudine use in two New Jersey cohorts. Health Serv Res 30(4):593–614
Devillanova C (2008) Social networks, information and health care utilization: evidence from undocumented immigrants in Milan. J Health Econ 27(2):265–286
Diggle PJ, Liang KY, Zeger SL (1994) Analysis of longitudinal data. Oxford University Press Inc, New York
Directorate-General of Budget (2003) Percentage share of disposable income by percentile group of households and income inequality indexes, 1964–2003. Report on the survey of family income and expenditure 2003, Taiwan
Dominick KL, Ahern FM, Gold CH, Heller DA (2003) Gender differences in NSAID use among older adults with osteoarthritis. Ann Pharmacother 37(11):1566–1571
Dunlop S, Coyte PC, McIsaac W (2000) Socio-economic status and the utilisation of physicians’ services: results from the Canadian National Population Health Survey. Soc Sci Med 51(1):123–133
Eastin MS, Guinsler NM (2006) Worried and wired: effects of health anxiety on information-seeking and health care utilization behaviors. Cyberpsychol Behav 9(4):494–498
Ferrell BA (1995) Pain evaluation and management in the nursing home. Ann Intern Med 123(9):681–687
Hetemaa T, Keskimaki I, Salomaa V, Mahonen M, Manderbacka K, Koskinen S (2004) Socioeconomic inequities in invasive cardiac procedures after first myocardial infarction in Finland in 1995. J Clin Epidemiol 57(3):301–308
Huang WF, Hsiao FY, Tsai YW, Wen YW, Shih YT (2006) Cardiovascular events associated with long-term use of celecoxib, rofecoxib and meloxicam in Taiwan: an observational study. Drug Saf 29(3):261–272
Huang N, Yip W, Chou YJ, Wang PJ (2007) The distribution of net benefits under the National Health Insurance programme in Taiwan. Health Policy Plan 22(1):49–59
Keefe FJ, Lefebvre JC, Egert JR, Affleck G, Sullivan MJ, Caldwell DS (2000) The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. Pain 87(3):325–334
Lu JF, Hsiao WC (2003) Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood) 22(3):77–88
Marmot M, Wilkinson. R, editors (1999) Social determinants of health. New York: Oxford University Press
Mulatu MS, Schooler C (2002) Causal connections between socio-economic status and health: reciprocal effects and mediating mechanisms. J Health Soc Behav 43(1):22–41
Pilote L, Joseph L, Belisle P, Penrod J (2003) Universal health insurance coverage does not eliminate inequities in access to cardiac procedures after acute myocardial infarction. Am Heart J 146(6):1030–1037
Poisal JA, Murray L (2001) Growing differences between Medicare beneficiaries with and without drug coverage. Health Aff (Millwood) 20(2):74–85
Roos NP, Mustard CA (1997) Variation in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and no. Milbank Q 75(1):89–111
Rosemann T, Joos S, Koerner T, Heiderhoff M, Laux G, Szecsenyi J (2006) Use of a patient information leaflet to influence patient decisions regarding mode of administration of NSAID medications in case of acute low back pain. Eur Spine J 15(11):1737–1741
Schillinger D, Barton LR, Karter AJ, Wang F, Adler N (2006) Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes. Public Health Rep 121(3):245–254
Stewart DE, Abbey SE, Shnek ZM, Irvine J, Grace SL (2004) Gender differences in health information needs and decisional preferences in patients recovering from an acute ischemic coronary event. Psychosom Med 66(1):42–48
Tsai JH, Cang HJ, Wang PJ (2005) The impact of increasing insurance contribution and co-payment on equity of national health insurance finance 2002. J Socl Sci Phil 17(1):1–31
Wang TF, Lin HC (2008) Relationship between caseload volume and outcome for systemic lupus erythematosus treatment: the experience of Taiwan. J Rheumatol 35(9):1795–1800
Warner TD, Mitchell JA (2004) Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J 18(7):790–804
Weisse CS, Sorum PC, Sanders KN, Syat BL (2001) Do gender and race affect decisions about pain management? J Gen Intern Med 16(4):211–217
Wong ST, Galbraith A, Kim S, Newacheck PW (2005) Disparities in the financial burden of children’s healthcare expenditures. Arch Pediatr Adolesc Med 159(11):1008–1013
Xu KT (2003) Financial disparities in prescription drug use between elderly and nonelderly Americans. Health Aff (Millwood) 22(5):210–221