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Associations of health services utilization by prescription drug coverage and immigration category in Ontario, Canada

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  • Antonipillai, Valentina
  • Guindon, G. Emmanuel
  • Sweetman, Arthur
  • Baumann, Andrea
  • Wahoush, Olive
  • Schwartz, Lisa

Abstract

Canada is the only high-income country with a universal healthcare system that does not provide prescription drug coverage for all its residents. This study examines whether Canadians’ prescription drug coverage status is associated with their health services use and how this association differs by gender across non-migrants and three categories of migrants: economic immigrants, family-class immigrants, and refugees. Very few studies have examined differences across these migrant groups, and there is a need to do so as they experience varying health disparities. This study contributes to the prescription drug coverage, migration and health literature by employing an intersectional lens to analyze a sample of Ontario working-aged residents (n=39,792) generated from linking the Canadian Community Health Survey (2005, 2008, 2013, 2014) and Longitudinal Immigrant Database. Predicted probabilities and average marginal effects from multivariable logistic regression models were generated, and interaction effects between prescription drug coverage and immigrant status were examined. The study reveals important differences in the use of health services across prescription drug coverage groups by immigration status. As the general debate about universal pharmacare in Canada is ongoing, this study reveals that drug insurance is positively associated with health services use of most migrants and non-migrants, however, some immigrant women may still experience barriers to access general practitioner services. If pharmacare is introduced, ongoing evaluation is needed to ensure that its implementation produces equitable outcomes for all.

Suggested Citation

  • Antonipillai, Valentina & Guindon, G. Emmanuel & Sweetman, Arthur & Baumann, Andrea & Wahoush, Olive & Schwartz, Lisa, 2021. "Associations of health services utilization by prescription drug coverage and immigration category in Ontario, Canada," Health Policy, Elsevier, vol. 125(10), pages 1311-1321.
    • Handle: RePEc:eee:hepoli:v:125:y:2021:i:10:p:1311-1321
    DOI: 10.1016/j.healthpol.2021.06.007
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    References listed on IDEAS

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    1. A. Hågå & J. M. Sverre, 2002. "Pricing and reimbursement of pharmaceuticals in Norway," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(3), pages 215-220, September.
    2. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics, Canadian Economics Association, vol. 34(4), pages 921-942, November.
    3. Dunn, James R. & Dyck, Isabel, 2000. "Social determinants of health in Canada's immigrant population: results from the National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(11), pages 1573-1593, December.
    4. Guo, Elaine Xiaoyu & Sweetman, Arthur & Guindon, G. Emmanuel, 2020. "Socioeconomic differences in prescription drug supplemental coverage in Canada: A repeated cross-sectional study," Health Policy, Elsevier, vol. 124(3), pages 252-260.
    5. Steve Morgan & Jamie R. Daw & Michael R. Law, 2013. "Rethinking Pharmacare in Canada," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 384, June.
    6. Cristina Hernández-Izquierdo & Beatriz González López-Valcárcel & Stephen Morris & Mariya Melnychuk & Ignacio Abásolo Alessón, 2019. "The effect of a change in co-payment on prescription drug demand in a National Health System: The case of 15 drug families by price elasticity of demand," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-39, March.
    7. Devlin, Rose Anne & Sarma, Sisira & Zhang, Qi, 2011. "The role of supplemental coverage in a universal health insurance system: Some Canadian evidence," Health Policy, Elsevier, vol. 100(1), pages 81-90, April.
    8. Sara Allin & Jeremiah Hurley, 2009. "Inequity in publicly funded physician care: what is the role of private prescription drug insurance?," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1218-1232, October.
    9. Marchildon, Gregory P. & Hutchison, Brian, 2016. "Primary care in Ontario, Canada: New proposals after 15 years of reform," Health Policy, Elsevier, vol. 120(7), pages 732-738.
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