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[莱里达(加泰罗尼亚)卫生区移民和本地人口药物支出的观察性研究]

[Observational study on drug spending in the immigrant and the indigenous population in the Lleida (Catalonia) health region].

作者信息

Rué Montse, Bosch Anna, Serna María-Catalina, Soler-González Jorge, Galván Leonardo, Cruz Inés

机构信息

Departament de Ciències Mèdiques Bàsiques, Facultat de Medicina, Universitat de Lleida, Lleida, España.

出版信息

Aten Primaria. 2010 Jun;42(6):328-37. doi: 10.1016/j.aprim.2009.12.010. Epub 2010 Apr 13.

Abstract

OBJECTIVE

To evaluate whether there are differences in drug spending between immigrant and Spanish-born populations and to assess whether drug consumption is associated with living environment (urban/rural).

DESIGN

Observational cross-sectional study.

SETTING

Lleida Health Region (LHR).

PARTICIPANTS

22,847 immigrants and 174,768 native born subjects, aged 15 to 64 years, residing in the LHR.

MAIN MEASUREMENTS

Drug spending during the year 2007, demographical variables, region of origin and residence area (urban/rural).

RESULTS

Native-born subjects spent more in all therapeutic drug groups than immigrants. In men, the relative risk ratio (RRR) of being in the highest quartile of expenditure was 3.2 (95% CI: 2.96-3.44) for native born versus immigrant and in women it was 2.1 (95% CI: 1.97-2.27). Immigrants from eastern Europe had the lowest risk of being in the highest quartile of expenditure, with statistically significant differences. Residents in the rural environment were more likely to have a higher pharmaceutical consumption than residents in the urban environment.

CONCLUSION

Inequalities in drug spending were observed between immigrants and native born subjects. Further studies, either qualitative or mixed, should explore which factors are related to these differences and propose strategies addressed to reducing them.

摘要

目的

评估移民人口与西班牙本土出生人口在药物支出方面是否存在差异,并评估药物消费是否与生活环境(城市/农村)相关。

设计

观察性横断面研究。

地点

莱里达健康区(LHR)。

参与者

居住在LHR的22847名移民和174768名15至64岁的本土出生者。

主要测量指标

2007年的药物支出、人口统计学变量、原籍地区和居住地区(城市/农村)。

结果

本土出生者在所有治疗药物组的支出均高于移民。在男性中,本土出生者与移民相比,处于最高支出四分位数的相对风险比(RRR)为3.2(95%CI:2.96 - 3.44),女性为2.1(95%CI:1.97 - 2.27)。来自东欧的移民处于最高支出四分位数的风险最低,差异具有统计学意义。农村环境中的居民比城市环境中的居民更有可能有较高的药物消费。

结论

观察到移民与本土出生者在药物支出方面存在不平等。进一步的定性或混合研究应探索哪些因素与这些差异相关,并提出减少这些差异的策略。

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本文引用的文献

1
Determinants of health care utilization by immigrants in Portugal.
BMC Health Serv Res. 2008 Oct 7;8:207. doi: 10.1186/1472-6963-8-207.
2
Race and ethnic disparities in valuing health.
Med Decis Making. 2008 Jan-Feb;28(1):12-20. doi: 10.1177/0272989X07309641.
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The self-reported health of immigrant groups in Switzerland.
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