Illicit drug overdose deaths resulting from income assistance payments: Analysis of the 'check effect' using daily mortality data
Illicit drug overdose deaths resulting from income assistance payments: Analysis of the 'check effect' using daily mortality data
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DOI：
10.1016/j.drugpo.2016.05.010
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发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
Buxton, Jane A.
中科院分区：
文献类型：
--
作者：
Otterstatter, Michael C.;Amlani, Ashraf;Buxton, Jane A.
背景资料：虽然收入援助是支助低收入个人的一个重要来源，但有证据表明，如果在同一天向所有受援者发放援助，不利后果可能会增加。本研究的目的是评估人口水平的非法药物过量死亡和收入援助金使用每日死亡率数据不列颠哥伦比亚省在一个为期五years.Methods：回顾性数据，每日死亡率非法药物过量，2009-2013年之间的时间模式和因果关系，由卑诗省验尸官服务。这些数据进行了分析，使用回归模型和时间序列检验因果关系的日期收入援助payment.Results：1343死亡，由于非法药物过量的报告在不列颠哥伦比亚省在2009年至2013年; 394发生在支票周（n = 60）和949发生在非支票周（n = 202）。与没有支付收入援助的周相比，由于非法药物过量导致的平均每周死亡率高出40%（P < 0.001）。支票支付后第二天，死亡率出现持续上升，并且在两天内显着升高，3天后略高，即使控制了其他时间趋势也是如此。格兰杰因果关系检验表明，支票发行的时间是因果关系的增加药物过量mortality（P < 0.001）。结论：我们的研究结果澄清的时间关系和因果关系的收入援助支付非法药物死亡。我们估计有77例可避免的死亡可归因于五年期间收入援助支票的同步支付。一个重要的考虑因素是，改变领取者的付款时间是否可以减少这种过高的死亡率以及对保健和社会服务的相关需求。(C)2016作者由爱思唯尔公司出版
Background: Although income assistance is an important source of support for low income individuals, there is evidence that adverse outcomes may increase when payments are disbursed on the same day for all recipients. The objective of this study was to assess the temporal patterns and causal relation between population-level illicit drug overdose deaths and income assistance payments using daily mortality data for British Columbia over a period of five years.Methods: Retrospective data on daily mortality due to illicit drug overdose, 2009-2013, were provided by the BC Coroners Service. These data were analyzed using regression models and time series tests for causality in relation to dates of income assistance payments.Results: 1343 deaths due to illicit drug overdose were reported in BC during 2009-2013; 394 occurred during cheque weeks (n = 60) and 949 occurred during non-cheque weeks (n = 202). Average weekly mortality due to illicit drug overdose was 40% higher during weeks of income assistance payments compared to weeks without payments (P < 0.001). Consistent increases in mortality appeared the day after cheque disbursement and were significantly higher for two days, and marginally higher after 3 days, even when controlling for other temporal trends. Granger causality testing suggests the timing of cheque issue was causally linked to increased drug overdose mortality (P < 0.001).Conclusions: Our findings clarify the temporal relation and causal impact of income assistance payments on illicit drug deaths. We estimate 77 avoidable deaths were attributable to the synchronized disbursement of income assistance cheques over the five year period. An important consideration is whether varying the timing of payments among recipients could reduce this excess mortality and the related demands on health and social services. (C) 2016 The Authors. Published by Elsevier B.V.