Antibiotic prescriptions for children in manitoba the changing socio economic gradient
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Antibiotic Prescriptions for Children in Manitoba: The Changing Socio-Economic Gradient. Canadian Public Health Association 2008 Annual Conference Halifax, Nova Scotia June 2, 2008 Marni Brownell, PhD University of Manitoba, Manitoba Centre for Health Policy. Co-Authors:

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Antibiotic prescriptions for children in manitoba the changing socio economic gradient

Antibiotic Prescriptions for Children in Manitoba: The Changing Socio-Economic Gradient

Canadian Public Health Association 2008 Annual Conference

Halifax, Nova Scotia

June 2, 2008

Marni Brownell, PhD

University of Manitoba, Manitoba Centre for Health Policy


Co-Authors: Changing Socio-Economic Gradient

Carolyn DeCoster, PhD, RN

Robert Penfold, PhD

Matthew Dahl, BSc

Shelley Derksen, MSc

Wendy Au, BSc

Jennifer Schultz, BA

Funding Sources:

Manitoba Centre for Health Policy

Manitoba Health and Healthy Living

The results and conclusions presented are those of the authors.  No official endorsement by Manitoba Health and Healthy Living is intended nor should be inferred

This work is preliminary and not for citation


Study objectives
Study Objectives Changing Socio-Economic Gradient

  • Part of a larger project to provide comprehensive information on child health status indicators for the Manitoba child population

  • Determine rates of children with at least one prescription for an antibiotic

    • Examine rates by area-level income

    • Examine changes in rates over time


Family Services Changing Socio-Economic Gradient

Education

Immunization

Hospital

Medical

Home Care

Nursing Home

Pharmaceuticals

Provider

Cost

Vital Statistics

Manitoba Population Health Research Data Repository

Population-Based Health Registry

Census Data at DA level

National surveys


Study population
Study population Changing Socio-Economic Gradient

  • All children aged 0-19 years residing in Winnipeg or Brandon in 2000/01 and 2005/06

  • Population denominator:

    • 2000/01 N=177,767

    • 2005/06 N=173,159


Methods
Methods Changing Socio-Economic Gradient

  • Area-level income assigned based on household income measure from 2001 Canada Census

  • urban population divided into quintiles - U1 – lowest urban income quintile U5 – highest urban income quintile

  • Rates adjusted for age and sex differences across income quintiles


Findings
Findings Changing Socio-Economic Gradient

  • Rate of children with one or more antibiotic prescriptions decreased significantly from 2000/01 to 2005/06:

    • from 481/1000 to 376/1000

  • Decreased the most for children from the lowest income quintile areas:


19% Changing Socio-Economic Gradient

23%

17%

16%

32%

Adjusted rate per 1000


What does this mean
What does this mean? Changing Socio-Economic Gradient

  • Perhaps greater decreases in inappropriate antibiotic prescribing for lowest income quintile kids?

  • To explore – looked at rates of antibiotic prescriptions for viral respiratory tract infections (from Kozyrskyj et al., 2004)

    • Matched prescriptions to diagnosis at physician visit (up to 7 days before prescription)


36% Changing Socio-Economic Gradient

23%


38% Changing Socio-Economic Gradient

23%


Conclusions
Conclusions Changing Socio-Economic Gradient

  • Antibiotic use has decreased significantly for Manitoba children

  • Decreases are greatest for children from the lowest urban income areas

  • Decreases are not only for inappropriate prescribing

  • Further research will explore the role of types of antibiotics in differential decreases across income quintiles


M Changing Socio-Economic Gradient

Manitoba

Centre for

Health

Policy

C

H

P

Questions?

www.umanitoba.ca/medicine/units/mchp/


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