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Published on: December 11, 2016
Unmet prescription medication need in U.S. children
Sandhya Mehta1, Saurabh Nagar, Rajender Aparasu
1Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Texas Medical Center, Houston, TX, USA.
Insights
Over half a million children in the U.S. faced unmet prescription medication needs (UPMN) due to cost, insurance issues, or health plan problems. Addressing racial disparities and ensuring continuous coverage are crucial for improving access to essential medicines for children.
Area of Science:
- Pediatric Health Outcomes
- Health Services Research
- Medication Access
Background:
- Unmet prescription medication need (UPMN) affects a significant portion of the pediatric population.
- Understanding the predictors of UPMN is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate the prevalence and characteristics of UPMN in children.
- To identify key predictors of UPMN, including cost, health plan issues, and insurance status.
Main Methods:
- Utilized data from the 2003 National Survey of Children's Health (NSCH), a population-based survey.
- Employed retrospective cross-sectional survey design with parents/guardians reporting on children's prescription medication use.
- Applied multivariate logistic regression to analyze predictors of UPMN within the Andersen behavioral model framework.
Main Results:
- Approximately 0.54 million children (1.23%) experienced UPMN.
- Higher prevalence observed in Black children, families below 200% federal poverty level, and those with fair/poor perceived health.
- Cost, health plan problems, and lack of insurance were primary reasons for UPMN, affecting 35%, 27%, and 41% of cases, respectively.
- Race, poverty, insurance status, perceived health, and depression were significant predictors of UPMN.
Conclusions:
- Over half a million children in the U.S. experience UPMN, primarily driven by financial and insurance-related barriers.
- Racial disparities and issues with continuity of health insurance coverage require attention to improve medication access for children.
- The findings highlight the need for policy interventions to ensure equitable access to prescription medications for pediatric populations.
Objectives:
To examine the nature and extent of unmet prescription medication need (UPMN) in children and its predictors using the 2003 National Survey of Children's Health (NSCH).
Design:
Retrospective cross-sectional survey.
Setting:
United States in 2003-2004.
Participants:
Parents or guardians who knew most about child's (<18 years of age) health and health care and reported about their children's prescription medication use.
Intervention:
NSCH-a population-based telephone survey-based on complex probability sampling design.
Main Outcome Measures:
Nature and extent of UPMN in children and predictors of UPMN for any reason and as a result of cost, health plan problems, and lack of insurance within the conceptual framework of the Andersen behavioral model.
Results:
According to NSCH, 0.54 million (95% CI 0.46-0.62) or 1.23% (1.05-1.41%) of children experienced UPMN. The highest prevalence of UPMN was seen among blacks (2.3%), families with income less than 200% of federal poverty level (2.4%), and those having good, fair, or poor perceived health status (3.2%). A high prevalence of UPMN was also found in children with gained (5.3%), lost (3.7%), or no insurance (6.4%). Among children with UPMN, 35.39% (28.56-42.23%) did not receive medications because of cost, 26.51% (20.28-32.74%) because of health plan problems, and 40.73% (33.21-48.24%) because of lack of insurance. Multivariate logistic regression analysis revealed that predisposing (race), enabling (poverty and insurance), and need (perceived health status and depression) factors were significantly associated with UPMN for any reason. Factors significantly associated with UPMN due to cost included enabling (insurance) and need (attention deficit hyperactivity disorder and asthma) factors. The predictors of UPMN resulting from health plan problems included predisposing (race) and enabling (insurance) factors, whereas UPMN caused by lack of insurance was only associated with an enabling factor (age).
Conclusion:
More than 0.5 million children in the United States experienced UPMN, mainly as a result of cost, health plan problems, or lack of insurance. The study findings suggest that a need exists for addressing racial disparities and continuity of coverage issues in children to improve access to needed prescription medications.
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