Suchergebnisse

Introduction: Mental health of Veterans remains a key public policy issue as Veterans with mental health conditions continue to rise in numbers. There is, however, limited information available about specific factors that are associated with mental health in the Veteran population in Canada despite the increasingly perilous nature of military engagements in recent decades. Methods: Regression analysis was conducted on data from a comprehensive self-reported health survey of Canadian Veterans to identify factors associated with mental health, which encompass post-traumatic stress disorders, anxiety disorders, depression, and mood disorders. Results: The findings uncover the role of service-oriented risk factors in the occurrence of mental health conditions notably, overseas deployment (OR=1.55, p≤0.001) and, to a limited extent, land forces (OR=1.34, p≤0.05). The results also show an inverse relationship between income and mental health. Further, lower-educated Veterans have increased odds of mental health conditions. Obesity was found to be a statistically significant factor associated with mental health (OR=1.45, p≤0.001) as well as smoking (OR=1.76, p≤0.001). Home ownership appears to have some protective effect on Veterans' health (OR=1.57, p≤0.001). Discussion: These findings highlight key important factors associated with mental health in Veterans, and they include overseas deployment, land forces enlistment, income, obesity, and smoking. The findings highlight the need for targeted research on the complex causal pathways leading to mental health conditions, especially in deployed Veterans and land forces Veterans so that effective prevention programs can be designed for these groups.

Introduction: Limited information is available about the determinants of chronic health conditions of Veterans despite the increasingly perilous nature of military engagements in recent decades. Methods: Econometric analysis, using probit and negative binomial models, was conducted on the basis of data from a cross-sectional self-reported health survey of Canadian Veterans to investigate the determinants of musculoskeletal, respiratory, gastrointestinal, and cardiovascular health conditions; pain; and diabetes. Results: The results stress the role of military service–related factors in the increased likelihood of chronic physical health conditions in Canadian Veterans. Army Veterans had an increased probability of musculoskeletal (0.08, p ≤ 0.001) and gastrointestinal (0.05, p ≤ 0.001) conditions and pain (0.07, p ≤ 0.01). Veterans who were deployed had an increased risk of musculoskeletal conditions (0.08, p ≤ 0.001) and pain (0.06, p ≤ 0.001). In terms of non–service-related factors, the results confirm the role of obesity as a statistically significant determinant of chronic musculoskeletal, respiratory, and cardiovascular conditions; pain; and diabetes. Female Veterans were also at higher risk of respiratory and gastrointestinal conditions. Low-income Veterans have increased probability of musculoskeletal, gastrointestinal, pain, and cardiovascular conditions, and the risk decreased with rising income level. Finally, Veterans with mental health conditions had increased odds of musculoskeletal (OR = 2.79, p ≤ 0.001), respiratory (OR = 2.40, p ≤ 0.001), gastrointestinal (3.66, p ≤ 0.001), pain (OR = 2.61, p ≤ 0.001), and cardiovascular (OR = 1.45, p ≤ 0.01) conditions and diabetes (OR = 1.37, p ≤ 0.05). Discussion: The findings have important clinical and health resource use implications as Veterans seek treatment in community settings once they transition from military to civilian life. They also serve to advance the research agenda on the health of Veterans, an understudied population in Canada.

Abstract.  Canadian household prescription drug expenditures are studied using the Statistics Canada Family Expenditure Survey masterfiles for periods that include the introduction of provincial 'general population' prescription drug programs. Budget shares for non‐senior households are examined over time using non‐parametric regression, parametric 'difference‐in‐difference' techniques, and quantile regression methods. The evidence suggests that while program effects are muted when there are high deductibles, a non‐senior prescription drug subsidy is more redistributive than an equal‐cost proportional income transfer, in part because of differential private health insurance coverage by income. This is in contrast to previous evidence on Canadian senior prescription drug subsidies. JEL classification: I18, J42

Canadian household prescription drug expenditures are studied using different years of the Statistics Canada Family Expenditure Survey. Master files are used, expanding the number of available years and permitting provincial rather than regional identifiers. Nonparametric Engel curves are estimated. Difference-in-difference mean and 80th percentile regressions examine budget shares by low-income and high-income households before and after the introduction of provincial prescription drug programs. The evidence is consistent with the view that unlike senior prescription drug subsidies, nonsenior prescription drug subsidies are probably more redistributive than an equal-cost proportional income transfer.

BACKGROUND: To monitor the magnitude of the drug shortage problem in Canada, since 2017, Health Canada has required manufacturers to report drug shortages. This study aimed to identify the factors associated with drug shortages in Canada. METHODS: We conducted a retrospective cohort study of all prescription drugs available on the market between Mar. 14, 2017, and Sept. 12, 2018, in Canada. All drugs of the same active ingredient, dosage form, route of administration and strength were grouped into a "market." Our main outcome was shortages at the market level, determined using the Drug Shortages Canada database. We used logistic regression to identify associated factors such as market structure, route or dosage form, and Anatomic Therapeutic Chemical (ATC) classification. RESULTS: Among the 3470 markets included in our analysis, 13.3% were reported to be in shortage. Markets with a single generic manufacturer were more likely to be in shortage than other markets. Markets with oral nonsolid route or dosage form were more likely to be in shortage than those that were oral solid with regular release (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.11 to 2.49). Markets for sensory organs were more likely to be in shortage than most other ATC classes. Markets with a higher proportion of drugs covered by public insurance programs were more likely to be in shortage (OR 1.03, 95% CI 1.00 to 1.05 per 10% increase). INTERPRETATION: Markets with a single generic manufacturer were most likely to be in shortage. To ensure the security of drug supply, governments should be vigilant in monitoring markets with a single generic manufacturer, with complex manufacturing processes, with higher demand from public programs or those that are in certain ATC classes.