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Differences in drug utilization between ethnic and socio-economic groups: does general practice population composition matter?

Dijk, L. van, Nielen, M., Vervloet, M., Uiters, E., Droomers, M. Differences in drug utilization between ethnic and socio-economic groups: does general practice population composition matter? European Journal of Public Health: 2010, 20(suppl. 1) 85. Abstract. 3rd European Public Health Conference 'Integrated Public Health', 10 - 13 November 2010, Amsterdam.
Background: To explore socio-economic and ethnic differences in receiving prescribed medication and to what extent these differences vary across general practices, with special interest whether or not the practice has a deprived patient population. Methods: Data were obtained by linkage of routine registration data collected in general practice (LINH) to the Dutch Population Registration (DPR) kept by Statistics Netherlands and the NIVEL index for GPs in deprived areas. Subjects were 86 677 patients aged 25–60 years registered in 80 general practices who consulted their GP at least once in 2007. Our main outcome measures were whether or not the patient received a prescription as well as the number of prescriptions written in 2007. Data were analysed using logistic and poisson multilevel modelling. Results: Non-Organization for Economic Co-operation and Development (OECD) migrants have a higher odds to receive a prescription from their general practitioner (GP) compared with the native patient population [odds ratio (OR) 1.16; 95% confidence interval (CI) 1.09–1.22], but they do not receive more prescriptions on average after controlling for the number of consultations. Income has no association with whether or not the patient receives medication, but once medication is prescribed, lower-income leads to an increased average number of prescriptions. In addition, the composition of the practice population in terms of the proportion of deprived patients does not influence the chance that patients from deprived areas (who have lower incomes and are more often non-OECD migrants) receive a prescription, nor does it have an impact on the average number of prescriptions these patients receive. Conclusions: Higher prescription rates in ethnic minorities can mainly be attributed to their higher use of GP care. Higher prescription
rates in deprived patient groups cannot be attributed to the fact that their GP has a more deprived population. Therefore, the increased workload of GPs with a more deprived population does not seem to lead to an overall increased use of medication. (aut. ref.)
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