Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada.
BMC Health Serv Res. 2010 Jun 17;10:171. doi: 10.1186/1472-6963-10-171.
In 2003, the government of British Columbia, Canada introduced a universal drug benefit plan to cover drug costs that are high relative to household income. Residents were required to register in order to be eligible for the income-based benefits. Given past research suggesting that registration processes may pose an access barrier to certain subpopulations, we aimed to determine whether registration rates varied across small geographic areas that differed in ethnic composition.
Using linked population-based administrative databases and census data, we conducted multivariate logistic regression analyses to determine whether the probability of registration for the public drug plan varied across areas of differing ethnic composition, controlling for household-level predisposing, enabling and needs factors.
The adjusted odds of registration did not differ across regions characterized by high concentrations (greater than 30%) of residents identifying as North American, British, French or other European. Households located in areas with concentrations of residents identifying as an Asian ethnicity had the highest odds of program registration: Chinese (OR = 1.21, CI: 1.19-1.23) and South Asian (OR = 1.19, CI: 1.16-1.22). Despite this positive finding, households residing in areas with relatively high concentrations of recent immigrants had slightly lower adjusted odds of registering for the program (OR = 0.97, CI: 0.95-0.98).
This study identified ethnic variation in registration for a new public drug benefit program in British Columbia. However, unlike previous studies, the variation observed did not indicate that areas with high concentrations of certain ethnicities experienced disadvantages. Potential explanations are discussed.
2003 年，加拿大不列颠哥伦比亚省政府推出了一项普遍的药物福利计划，以覆盖相对于家庭收入较高的药物费用。居民需要注册才有资格获得基于收入的福利。鉴于过去的研究表明，注册过程可能对某些亚人群构成获得药物的障碍，我们旨在确定在种族构成不同的小地理区域，注册率是否存在差异。
我们使用链接的基于人群的行政数据库和人口普查数据，进行多变量逻辑回归分析，以确定在具有不同种族构成的区域中，公共药物计划的注册概率是否存在差异，同时控制家庭层面的倾向、促成和需求因素。
调整后的注册几率在以北美、英国、法国或其他欧洲裔居民占比高（大于 30%）为特征的区域之间没有差异。居住在以亚洲裔居民为特征的区域的家庭，其注册该计划的几率最高：华裔（OR=1.21，CI：1.19-1.23）和南亚裔（OR=1.19，CI：1.16-1.22）。尽管有此积极发现，但居住在最近移民相对集中的地区的家庭，注册该计划的调整后几率略低（OR=0.97，CI：0.95-0.98）。
本研究确定了不列颠哥伦比亚省一项新的公共药物福利计划的注册在种族方面的差异。然而，与之前的研究不同，观察到的差异并未表明某些种族集中的地区存在劣势。讨论了潜在的解释。
