Department of Economics, Faculty of Administrative Sciences, Health Economics and Health Policy Research and Application Center, Hacettepe University, Ankara, Turkey.
Department of Economics, Faculty of Administrative Sciences, Middle East Technical University, Ankara, Turkey.
Daru. 2019 Dec;27(2):735-742. doi: 10.1007/s40199-019-00311-1. Epub 2019 Nov 16.
Demographic and socio-economic factors determine pharmaceutical health care utilization for individuals. Prescription and non-prescription medicine use are expected to have different determinants. Even though prescription and non-prescription medicine use is being well researched for developed countries, there are only a few studies for developing countries.
This paper aims to analyze the socio-economic and individual characteristics that determine the use of prescription and non-prescription medicine. We examine the issue for the specific case of Turkey since Turkey's health system has undertaken significant changes in the last two decades and especially after 2003 with the "Health Transformation Programme".
Data from the nationally representative "Health Survey" are used in the analysis. The data set covers the 2008-2016 period with two-year intervals. Pooled multivariate logistic regression is employed to identify the underlying determinants of prescription and non-prescription medicine use.
When compared to 2008, non-prescription medicine use decreases until 2012, however, an increasing trend appears after 2012. For prescription medicine use, a decreasing trend emerges after 2012. Findings from the marginal effects indicate that for non-prescription medicine use, the highest effect stems from the health status. For prescription medicine use, the highest marginal effects arise from age, health and employment status indicating the importance of the need and predisposing factors.
Decreasing non-prescription medicine use largely depends on easier access to health care service utilization. Although having a health insurance has a positive relationship with prescription medicine use, there is still a problem for individuals living a rural area and heaving a lower income level since they are more likely to use non-prescription medicine.
人口统计和社会经济因素决定了个人的药品医疗保健利用。预计处方药和非处方药的使用有不同的决定因素。尽管处方药和非处方药的使用在发达国家得到了很好的研究，但发展中国家的研究却很少。
本文旨在分析决定处方药和非处方药使用的社会经济和个人特征。我们以土耳其为例研究这个问题，因为土耳其的卫生系统在过去二十年中经历了重大变革，特别是 2003 年“卫生转型计划”以来。
分析使用了来自全国代表性的“健康调查”的数据。该数据集涵盖了 2008-2016 年，每两年间隔一次。采用多变量逻辑回归模型来确定处方药和非处方药使用的潜在决定因素。
与 2008 年相比，非处方药的使用在 2012 年之前呈下降趋势，但在 2012 年之后出现上升趋势。对于处方药的使用，2012 年之后出现下降趋势。边际效应的结果表明，对于非处方药的使用，健康状况的影响最大。对于处方药的使用，年龄、健康和就业状况的最高边际效应表明需要和倾向因素的重要性。
非处方药使用的减少在很大程度上取决于更容易获得医疗服务的利用。尽管拥有健康保险与处方药的使用呈正相关，但对于生活在农村地区和收入水平较低的个人来说，仍然存在问题，因为他们更有可能使用非处方药。
