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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:

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

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  1. 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

  2. Co-Authors: 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endorsement by Manitoba Health and Healthy Living is intended nor should be inferred This work is preliminary and not for citation

  3. Study Objectives • 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

  4. Family Services 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

  5. Study population • 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

  6. Methods • 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

  7. Findings • 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:

  8. 19% 23% 17% 16% 32% Adjusted rate per 1000

  9. What does this mean? • 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)

  10. 36% 23%

  11. 38% 23%

  12. Conclusions • 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

  13. M Manitoba Centre for Health Policy C H P Questions? www.umanitoba.ca/medicine/units/mchp/

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