Sarma Sisira, Basu Kisalaya, Gupta Anil
Microsimulation Modelling and Data Analysis Division, Applied Research and Analysis Directorate, Health Policy Branch, Health Canada, Ottawa, Ontario, Canada.
Soc Sci Med. 2007 Dec;65(12):2553-65. doi: 10.1016/j.socscimed.2007.07.015. Epub 2007 Aug 29.
Using 2002 Canadian Community Health Survey data, this paper examines the effect of public and private prescription drug insurance on the utilization of psychotropic and non-psychotropic drugs. It is found that prescription drug utilization is characterized by two stochastic regimes requiring use of latent class modelling framework. In many instances, results differ for the classes of high and low users of prescription drugs. After accounting for the unobserved individual heterogeneity and a number of socio-demographic factors, health status, and province fixed effects, we find that having prescription drug insurance (public or private) increases the expected number of non-psychotropic medications for both low and high users. Public insurance affects psychotropic drug utilization positively for the low-user group only. The statistical insignificance of insurance for the high-user psychotropic drugs or lower magnitude of insurance coefficients on high-user non-psychotropic drugs seems to stem from high inelastic demand for prescription drugs in the concerned groups. In addition, we find that age, self-reported health status, and long-term mental and physical health problem diagnosed by a health professional are important determinants of prescription drug utilization for both classes of users.
本文利用2002年加拿大社区健康调查数据,研究了公共和私人处方药保险对精神类药物和非精神类药物使用的影响。研究发现,处方药的使用具有两种随机模式,需要使用潜在类别建模框架。在许多情况下,处方药高使用者和低使用者类别的结果有所不同。在考虑了未观察到的个体异质性、一些社会人口因素、健康状况和省份固定效应后,我们发现拥有处方药保险(公共或私人)会增加低使用者和高使用者非精神类药物的预期使用量。公共保险仅对低使用者群体的精神类药物使用有积极影响。高使用者精神类药物保险的统计不显著性或高使用者非精神类药物保险系数的较低幅度似乎源于相关群体对处方药的高弹性需求。此外,我们发现年龄、自我报告的健康状况以及由健康专业人员诊断出的长期身心健康问题是两类使用者处方药使用的重要决定因素。