Item – Theses Canada

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OCLC number
1335712896
Link(s) to full text
LAC copy
Author
Pulcins, Indra R.
Title
Socioeconomic determinants of prescription drug use by the elderly in British Columbia.
Degree
Ph.D. -- University of Toronto, 2000.
Publisher
[Toronto, Ontario] : University of Toronto, 2000
Description
1 online resource
Abstract
This dissertation examines the socioeconomic determinants of prescription drug use by the elderly in British Columbia between 1989 and 1995. The objectives of this research are to describe drug utilization by the elderly in British Columbia as it varies by socioeconomic status, and to determine whether there exists a socioeconomic gradient in rates of drug use after controlling for demographic factors and other health care utilization. These relationships are explored in detailed for gastrointestinal, central nervous system and cardiovascular medications. Data sources include the British Columbia Linked Health Database and Canadian Census data. All individuals 65 years of age and over who subscribed to Plan A of Pharmacare, the provincial drug plan, are included in this analysis. Socioeconomic status is measured in terms of income quintiles, an area-based measure of average household income. Bivariate descriptive analytic techniques and multiple regression analysis were employed. The results of this study confirm the presence of an inverse, monotonic relationship between income and patterns of prescription drug use. Per capita utilization of gastrointestinal, central nervous system and cardiovascular drugs increases as income decreases. An examination of utilization rates per user, which consider only those individuals receiving at least one drug in each therapeutic drug group, reveals similar gradients, with the exception of cardiovascular drugs. Although the quantity of drugs dispensed and number prescriptions for cardiovascular drugs increase monotonically as income decreases, income level has no effect on drug costs. There is some evidence that the type of cardiovascular medications prescribed varies by income level. Multiple regression analysis demonstrates that despite the significant effect of physician, hospital and home care use on the amount of prescription drugs dispensed, income still emerges as a significant predictor of drug utilization. These results point to the existence of systematic differences in the utilization of prescription drugs. The extent to which these are due to socially determined differences in treatment, or to differences in the health status, is not known. Further research in this area would refine our knowledge of the relationships between drug utilization, socioeconomic status and need.
Other link(s)
hdl.handle.net
www.collectionscanada.ca
tspace.library.utoronto.ca