Socioeconomic factors, morbidity and drug utilization—an ecological study

✍ Scribed by Karin Henricson; Pål Stenberg; Gerhard Rametsteiner; Jonas Ranstam; Bertil S. Hanson; Arne Melander

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 111 KB
• Volume: 7
• Category: Article
• ISSN: 1053-8569
• DOI: 10.1002/(sici)1099-1557(199807/08)7:4<261::aid-pds364>3.0.co;2-x

✦ Synopsis

The aim of the present study was to elucidate the relations between demographic and socioeconomic factors, morbidity and the utilization of major drug groups in an urban Swedish population. The study was performed as an ecological analysis during November 1991 in the 17 dierent districts of MalmoÈ , the third largest Swedish city (235,000 inhabitants).

The material comprised 86,228 ACT-coded drug items which corresponded to 76% of all prescriptions dispensed during the study month. Of these, 43,032, dispensed to patients aged 15±64 years, were analysed in the present work. Age standardized drug utilization was expressed as the number of dispensed De®ned Daily Doses per 1000 inhabitants per day. Morbidity was measured in terms of reimbursed days on sick leave. The sociodemographic parameters used were socioeconomic status (SES), employment rate, median income per family, households on social allowance, and ethnicity.

For four of the ®ve major pharmacological groups (ATC-groups A, C, J, N and R, i.e. alimentation, circulation, infectious diseases, nervous system and respiration), most pronouncedly group N and least so group R, utilization correlated positively with not only the extent of morbidity but also with an unfavourable socioeconomic situation, high proportion of immigrants, and households on social allowance or with low income and/or with a low employment rate. The utilization of antibiotics (group J), however, instead correlated negatively with these parameters. For all ®ve drug groups, these trends were similar among men and women, albeit with varying strength.

In conclusion, socioeconomic factors may have a profound in¯uence on the utilization of several major drug groups. At least in the case of antibiotics, the consequence of this in¯uence is irrational drug use.