Socioeconomic inequalities in drug utilization for Sweden: Evidence from linked survey and register data

Nordin, Martin; Dackehag, Margareta; Gerdtham, Ulf G.

doi:10.1016/j.socscimed.2012.11.013

Cited by 32 publications

(32 citation statements)

References 28 publications

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“…However, there was an association with newer anti-hyperglycemic medication which is also more expensive. Similar results were reported in a recent study from Sweden, where drug utilization was associated with education, but not with income [32]. The authors could not explain their findings.…”

Section: Discussionsupporting

confidence: 70%

Treatment Pattern of Type 2 Diabetes Differs in Two German Regions and with Patients' Socioeconomic Position

et al. 2014

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BackgroundDiabetes treatment may differ by region and patients' socioeconomic position. This may be particularly true for newer drugs. However, data are highly limited.MethodsWe examined pooled individual data of two population-based German studies, KORA F4 (Cooperative Health Research in the Region of Augsburg, south), and the HNR (Heinz Nixdorf Recall study, west) both carried out 2006 to 2008. To ascertain the association between region and educational level with anti-hyperglycemic medication we fitted poisson regression models with robust error variance for any and newer anti-hyperglycemic medication, adjusting for age, sex, diabetes duration, BMI, cardiovascular disease, lifestyle, and insurance status.ResultsThe examined sample comprised 662 participants with self-reported type 2 diabetes (KORA F4: 83 women, 111 men; HNR: 183 women, 285 men). The probability to receive any anti-hyperglycemic drug as well as to be treated with newer anti-hyperglycemic drugs such as insulin analogues, thiazolidinediones, or glinides was significantly increased in southern compared to western Germany (prevalence ratio (PR); 95% CI: 1.12; 1.02–1.22, 1.52;1.10–2.11 respectively). Individuals with lower educational level tended to receive anti-hyperglycemic drugs more likely than their better educated counterparts (PR; 95% CI univariable: 1.10; 0.99–1.22; fully adjusted: 1.10; 0.98–1.23). In contrast, lower education was associated with a lower estimated probability to receive newer drugs among those with any anti-hyperglycemic drugs (PR low vs. high education: 0.66; 0.48–0.91; fully adjusted: 0.68; 0.47–0.996).ConclusionsWe found regional and individual social disparities in overall and newer anti-hyperglycemic medication which were not explained by other confounders. Further research is needed.

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Section: Discussionsupporting

confidence: 70%

Treatment Pattern of Type 2 Diabetes Differs in Two German Regions and with Patients' Socioeconomic Position

et al. 2014

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“…Meanwhile, the adult children of parents with a tertiary education had a lower risk of using medicines than the individuals who were raised by parents with a secondary education (with the exception of dermatological medicines and parasitical products). These findings are consistent with those of previous studies on the educational gradient in the consumption of medicines (Nordin et al 2013). In addition to the analyses presented in Tables 5−7, we carried out sensitivity analyses in order to check the robustness of our results.…”

Section: Instrumental Variable Models: Results From the Second Stagesupporting

confidence: 93%

“…Recent research that compared the data from the Prescribed Drug Registry with disease incidence and prevalence showed that in Sweden, medicines are largely prescribed and dispensed according to need (Nordin, Dackehag, and Gerdtham 2013;Weitoft et al 2008). There are, however, some exceptions; for example, antibiotics, hormone replacement drugs, and anti-migraine drugs are used by some socioeconomic subgroups more frequently than would be predicted based on disease incidence and prevalence data.…”

Section: Datamentioning

confidence: 99%

Does the number of siblings affect health in midlife? Evidence from the Swedish Prescribed Drug Register

Baranowska-Rataj

Luna

Ivarsson

2016

DemRes

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“…A previous study in Swedish children found low socio-economic status to be related to higher incidence of late onset wheeze, when based on self-reported data of diagnosis or wheeze [31]. However, a recent Swedish study did not find income to be a predictor for dispense of drugs, after controlling for health status, but there was higher prescription rate toward people with high education [32]. However, since we had individual level data on socio-economic status we could address this by adjustment and restriction on different socio-economic indices, which did not affect the result, and thus this is not a likely source of bias for the results in our study.…”

Section: Discussionmentioning

confidence: 99%

Asthma incidence in children growing up close to traffic: a registry-based birth cohort

2013

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BackgroundRecent reviews conclude an association between traffic-related pollution and incidence of asthma in children, but not all studies agree. Studies have almost exclusively relied on parental-reported symptoms or parental-reported diagnoses of asthma and wheeze. Our aim was to investigate if traffic exposure is associated with higher incidence of early onset asthma, using registry-based outcome data.MethodsWe investigated a birth cohort in southern Sweden, consisting of N = 26 128 children with outcome and exposure data (born July 2005–2010). Of these children, N = 7898 had additional covariate information. The cohort was followed to the end of 2011.Traffic intensity, and dispersion-modeled concentrations of NOX (100×100 m grid), at residential addresses, were linked with registry data on dispensed asthma medication (the Swedish Prescribed Drug Register), and hospital and primary health care diagnoses of bronchiolitis, obstructive bronchitis and asthma (The Scania Health Care Register).Covariate information was obtained from questionnaires distributed to parents at Child Health Care-centre visits, eight months after birth. Cox proportional hazards regression was used for the statistical analyses.ResultsLiving in close proximity to a road with ≥8640 cars/day (compared to 0–8640 cars/day), was not associated with higher incidence of first purchase of inhaled β2-agonist (adjusted hazard ratio (adj.HR) = 0.9, 95% CI: 0.8-1.0); third year purchase of inhaled β2-agonist (adj.HR = 0.7, 95% CI: 0.6-0.9); bronchiolitis (adj.HR = 0.7, 95% CI: 0.6-0.9), obstructive bronchitis (adj.HR = 1.0, 95% CI: 0.9-1.2), or asthma (adj.HR = 0.7, 95% CI: 0.6- 0.9). Similar results were found for inhaled corticosteroids, and in relation to NOX.ConclusionsTraffic-related exposure was not associated with higher incidence of asthma medication, or diagnoses of asthma, bronchiolitis, or obstructive bronchitis, in children 0–6 years in southern Sweden. This may depend on the low levels of traffic pollution in the area, mainly well below the WHO-guideline for NO2.

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Socioeconomic inequalities in drug utilization for Sweden: Evidence from linked survey and register data

Cited by 32 publications

References 28 publications

Treatment Pattern of Type 2 Diabetes Differs in Two German Regions and with Patients' Socioeconomic Position

Treatment Pattern of Type 2 Diabetes Differs in Two German Regions and with Patients' Socioeconomic Position

Does the number of siblings affect health in midlife? Evidence from the Swedish Prescribed Drug Register

Asthma incidence in children growing up close to traffic: a registry-based birth cohort

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