TABLE 5.
Explanatory Factors of 1-Month Medication Noninitiation in the Pediatric Population Based on the Multilevel Multivariate Regression Model: ORs and 95% CIs
| OR | 95% CI | |
|---|---|---|
| Female sex (versus male) | 1.01 | 0.99–1.02 |
| Age groups, y | ||
| 0–1 | 1.29* | 1.26–1.32* |
| 2–4 | 1.29* | 1.27–1.31* |
| 5–11 | Reference | Reference |
| 12–14 | 1.21* | 1.19–1.23* |
| 15–17 | 1.50* | 1.48–1.53* |
| Copayment level (patient profile)a | ||
| 0% (pensioner and nonpensioner: annual income ≤€5000) | 5.18* | 4.16–6.45* |
| 10% (pensioner: annual income ∼€5000–100 000)b | 0.45* | 0.44–0.47* |
| 40% (nonpensioner: annual income ∼€5000–18 000) | Reference | Reference |
| 50% (nonpensioner: annual income €18 000–100 000) | 0.76* | 0.75–0.77* |
| 60% (pensioner and nonpensioner: annual income >€100 000) | 0.73* | 0.67–0.80* |
| Medication cost assumed by the patientc | ||
| €0 | Reference | Reference |
| >€0–2 | 16.11* | 12.97–20.00* |
| >€2 | 11.71* | 9.43–14.54* |
| No. new prescriptions (continuous)d | 0.92* | 0.91–0.92* |
| Active diagnoses (ICD-10) at the moment of prescription (versus not active) | ||
| Certain infectious and parasitic diseases (A–B) | 1.03 | 1.01–1.04 |
| Neoplasms (C–D48) | 0.97 | 0.94–0.99 |
| Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50–D89) | 0.93 | 0.90–0.97 |
| Diabetes mellitus (E10E14) | 0.96 | 0.84–1.09 |
| Other endocrine, nutritional and metabolic diseases (E) | 0.92 | 0.90–0.94 |
| Behavioral and emotional disorders with onset in childhood (F90, F91, F93–F95) | 1.02 | 0.99–1.04 |
| Other mental and behavioral disorders (F) | 0.96 | 0.94–0.98 |
| Diseases of the nervous system (G) | 1.01 | 0.97–1.04 |
| Diseases of the eye and adnexa; of the ear and mastoid process (H) | 0.87* | 0.86–0.88* |
| Diseases of the circulatory system (I) | 1.02 | 1.00–1.04 |
| Asthma (J44–J46, J82) | 1.02 | 1.00–1.05 |
| Other diseases of the respiratory system (J) | 0.75* | 0.75–0.76* |
| Diseases of the digestive system (K) | 0.94 | 0.93–0.95 |
| Diseases of the skin and subcutaneous tissue (L) | 1.01 | 1.00–1.02 |
| Diseases of the musculoskeletal system and connective tissue (M) | 1.00 | 0.98–1.01 |
| Diseases of the genitourinary system (N) | 0.98 | 0.96–1.01 |
| Pregnancy, childbirth and the puerperium (O) | 1.00 | 0.89–1.12 |
| Certain conditions originating in the perinatal period (P) | 0.95 | 0.93–0.98 |
| Congenital malformations. deformations and chromosomal abnormalities (Q) | 0.97 | 0.96–0.99 |
| Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R) | 1.00 | 0.98–1.01 |
| External causes (S, T, V, X, Y)e | 1.22* | 1.19–1.24* |
| Use of PC health care services made by the patient | ||
| Appointments with a PC social worker (versus no attendance)f | 1.05 | 1.00–1.09 |
| Visits to a PC clinician (continuous)d | 0.99 | 0.99–0.99 |
| Visits to a PC nurse (continuous)d | 1.00 | 1.00–1.01 |
| Specialty of the prescribing clinician | ||
| Pediatrician, including PC and SC | Reference | Reference |
| PC clinician, includes general practitioners and family physicians | 1.16* | 1.15–1.18* |
| SC clinician | 1.55* | 1.51–1.59* |
| Characteristics of the center | ||
| PC center | Reference | Reference |
| After-hours PC centerg | 1.04 | 1.02–1.06 |
| SC center | 1.53* | 1.50–1.55* |
Prescription was the unit of analysis.
Information recorded at the time of prescription was used for time-dependent variables.
Pensioners up to €100 000 annual income have a ceiling cap based on annual income.
The amount (in euros) to be paid by the patient in the pharmacy to obtain the prescribed medication.
New prescriptions (excluding the index prescription) during the year before the new prescription assessed.
Including injury, poisoning, and certain other consequences of external causes.
During the study period (July 2017 to June 2018).
This group includes only those specific emergency ambulatory care centers: Centre d'Urgències d'Atenció Primària, Atenció Continuada i de les Urgències de base Territorial, Centre d'Atenció Continuada, Punts d'Atenció Continuada, and dispositius d’atenció urgent aïllats o de muntanya. For the other 2 types of centers (PC or SC), we cannot differentiate whether the visit was scheduled or urgent or unscheduled.
A statistically significant (P < .05) and clinically significant association between the independent variable and 1-mo noninitiation: in categorical variables (OR <0.9 or >1.1) or in continuous variables (OR <0.99 or >1.01).