Document Detail

Variation in the use of medicines by ethnicity during 2006/07 in New Zealand: a preliminary analysis.
MedLine Citation:
PMID:  24162628     Owner:  NLM     Status:  In-Data-Review    
AIM: To describe variations in dispensing of specific medication groups by ethnicity in New Zealand, adjusting for health need.
METHOD: Preliminary linkage of dispensings of prescription medicines in 2006/07 to age/disease burden proxies of health need for Maori, Pacific peoples (Pasifika)--who are mostly of Samoan, Tongan, Niuean, or Cook Islands descent--in New Zealand, and non-Maori/non-Pasifika. These disease burden proxies combine differences in prevalence, age, morbidity, and mortality. Variations were disaggregated by patients being first dispensed medicines ('access') versus subsequent dispensings ('persistence').
RESULTS: Initially, overall age-adjusted incidence of 'scripts' (prescriptions dispensed) to Maori was similar to that of non-Maori. There were differences in therapeutic coverage between Maori and Pasifika, for example greater use of asthma medicines in Maori. However, further adjustments linking with disease burden showed marked variance for a number of diseases. Differences in dispensing included areas of high health need such as heart disease, infections, diabetes, mental health and respiratory disease. Maori had 19-37% lower dispensings overall than non-Maori, with a net difference of nearly 1 million scripts. Maori were both less likely to access medicines, and then after first dispensing had fewer subsequent scripts. Patterns for Pasifika appeared similar, although needs-adjusted analysis is awaited for this population.
CONCLUSIONS: Once adjusting for need, there was variable but sizeable differences in medicines dispensed to Maori compared with non-Maori, and likely differences for Pasifika populations. There are however important limitations to this preliminary analysis. Crude and age-standardised metrics may be poor predictors of needs-adjusted gaps in medicines use. In this analysis, solely age-standardised rates tended to underestimate differences once adjusting for burden of disease; future analyses of prescribing patterns should consider better adjusting for disease burden.
Scott Metcalfe; George Laking; Jason Arnold
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Publication Detail:
Type:  Journal Article     Date:  2013-10-18
Journal Detail:
Title:  The New Zealand medical journal     Volume:  126     ISSN:  1175-8716     ISO Abbreviation:  N. Z. Med. J.     Publication Date:  2013  
Date Detail:
Created Date:  2013-10-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401067     Medline TA:  N Z Med J     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  14-41     Citation Subset:  IM    
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