Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand

Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Jiraluck Nontarak [verfasserIn] Polathep Vichitkunakorn [verfasserIn] Orratai Waleewong [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs)

Übergeordnetes Werk:	In: International Journal for Equity in Health - BMC, 2003, 22(2023), 1, Seite 9
Übergeordnetes Werk:	volume:22 ; year:2023 ; number:1 ; pages:9

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12939-023-01845-2

Katalog-ID:	DOAJ087763087

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520			\|a Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.
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allfields	10.1186/s12939-023-01845-2 doi (DE-627)DOAJ087763087 (DE-599)DOAJ0f2de15ca175465288b53e967976a394 DE-627 ger DE-627 rakwb eng RA1-1270 Jiraluck Nontarak verfasserin aut Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs) Public aspects of medicine Polathep Vichitkunakorn verfasserin aut Orratai Waleewong verfasserin aut In International Journal for Equity in Health BMC, 2003 22(2023), 1, Seite 9 (DE-627)356253716 (DE-600)2092056-8 14759276 nnns volume:22 year:2023 number:1 pages:9 https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/article/0f2de15ca175465288b53e967976a394 kostenfrei https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/toc/1475-9276 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 22 2023 1 9
spelling	10.1186/s12939-023-01845-2 doi (DE-627)DOAJ087763087 (DE-599)DOAJ0f2de15ca175465288b53e967976a394 DE-627 ger DE-627 rakwb eng RA1-1270 Jiraluck Nontarak verfasserin aut Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs) Public aspects of medicine Polathep Vichitkunakorn verfasserin aut Orratai Waleewong verfasserin aut In International Journal for Equity in Health BMC, 2003 22(2023), 1, Seite 9 (DE-627)356253716 (DE-600)2092056-8 14759276 nnns volume:22 year:2023 number:1 pages:9 https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/article/0f2de15ca175465288b53e967976a394 kostenfrei https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/toc/1475-9276 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 22 2023 1 9
allfields_unstemmed	10.1186/s12939-023-01845-2 doi (DE-627)DOAJ087763087 (DE-599)DOAJ0f2de15ca175465288b53e967976a394 DE-627 ger DE-627 rakwb eng RA1-1270 Jiraluck Nontarak verfasserin aut Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs) Public aspects of medicine Polathep Vichitkunakorn verfasserin aut Orratai Waleewong verfasserin aut In International Journal for Equity in Health BMC, 2003 22(2023), 1, Seite 9 (DE-627)356253716 (DE-600)2092056-8 14759276 nnns volume:22 year:2023 number:1 pages:9 https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/article/0f2de15ca175465288b53e967976a394 kostenfrei https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/toc/1475-9276 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 22 2023 1 9
allfieldsGer	10.1186/s12939-023-01845-2 doi (DE-627)DOAJ087763087 (DE-599)DOAJ0f2de15ca175465288b53e967976a394 DE-627 ger DE-627 rakwb eng RA1-1270 Jiraluck Nontarak verfasserin aut Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs) Public aspects of medicine Polathep Vichitkunakorn verfasserin aut Orratai Waleewong verfasserin aut In International Journal for Equity in Health BMC, 2003 22(2023), 1, Seite 9 (DE-627)356253716 (DE-600)2092056-8 14759276 nnns volume:22 year:2023 number:1 pages:9 https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/article/0f2de15ca175465288b53e967976a394 kostenfrei https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/toc/1475-9276 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 22 2023 1 9
allfieldsSound	10.1186/s12939-023-01845-2 doi (DE-627)DOAJ087763087 (DE-599)DOAJ0f2de15ca175465288b53e967976a394 DE-627 ger DE-627 rakwb eng RA1-1270 Jiraluck Nontarak verfasserin aut Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap. Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs) Public aspects of medicine Polathep Vichitkunakorn verfasserin aut Orratai Waleewong verfasserin aut In International Journal for Equity in Health BMC, 2003 22(2023), 1, Seite 9 (DE-627)356253716 (DE-600)2092056-8 14759276 nnns volume:22 year:2023 number:1 pages:9 https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/article/0f2de15ca175465288b53e967976a394 kostenfrei https://doi.org/10.1186/s12939-023-01845-2 kostenfrei https://doaj.org/toc/1475-9276 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 22 2023 1 9
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Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. 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topic_title	RA1-1270 Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand Health inequality Medication delivery services Medicine reception COVID-19 Noncommunicable disease (NCDs)
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title	Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand
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title_full	Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand
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journal	International Journal for Equity in Health
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title_sort	inequalities in access to new medication delivery services among non-communicable disease patients during the covid-19 pandemic: findings from nationally representative surveys in thailand
callnumber	RA1-1270
title_auth	Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand
abstract	Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.
abstractGer	Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.
abstract_unstemmed	Abstract Background This study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients. Methods Data were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates. Results Among 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles. Conclusions This study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.
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title_short	Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand
url	https://doi.org/10.1186/s12939-023-01845-2 https://doaj.org/article/0f2de15ca175465288b53e967976a394 https://doaj.org/toc/1475-9276
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Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand

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