91 Medication use by insurance coverage in the Southern Cone of Latin America 4 Co-variates Number of medications ≥1 Medication ≥2 Medications Reported barriers to needed care Public coverage only 1.07 (1.00-1.13) 2.94 (0.87-10.64) 1.27 (0.77-2.11) 2.57 (1.32 – 5.01) Age 1.01 (1.01-1.01) 1.02 (0.93-1.12) 1.07 (1.04-1.10) 0.98 (0.95 – 1.01) Male 1.18 (1.11-1.25) 1.54 (0.39-6.97) 2.17 (1.33-3.57) 0.84 (0.46 – 1.55) Coronary revascularization 0.76 (0.72-0.81) 0.11 (0.00-0.71) 0.33 (0.18-0.59) 1.08 (0.41 – 2.88) Secondary education 1.04 (0.97-1.11) 0.55 (0.12-2.37) 1.21 (0.70-2.11) 1.40 (0.72 – 2.71) University education 1.07 (0.98-1.17) 1.13 (0.1—44.81) 0.96 (0.47-2.00) 1.70 (0.68 – 4.26) Reported healthcare barriers 1.03 (0.95-1.11) 0.51 (0.11-2.76) 1.24 (0.68-2.32) - Table 2. Results from multivariable analysis. Note: Results are expressed in rate ratios (95% confidence intervals) for the numerical outcome (number of medications), and in odds ratios (95% confidence intervals) for the categorical outcomes (≥1 medication, ≥2 medications and reported barriers to needed care). There were significant differences between coverage groups in reporting specific healthcare barriers: inability to make an appointment fast enough (9.7% vs. 2.8%, p=0.003), being unable to afford prescription drugs (8.3% vs. 3.4%, p=0.040) and being unable to afford visiting a doctor (9.8% vs. 3.1%, p=0.005) were significantly more common among participants covered only by the public sector. More uninsured participants reported to be unable to afford medical care (5.4% vs. 3.4%), though this difference was not statistically significant (Table 3). DISCUSSION Summary of main results Our findings show that more than half of the CESCAS participants with established CHD are covered exclusively by the public insurance. The use of most recommended medications Reported barriers to healthcare use (%) Additional coverage Public coverage only Overall p N 251 342 593 Could not receive needed medical care 13.2 26.1 21.7 0.001 Could not get an appointment fast enough 2.8 9.7 8.0 0.003 Could not afford medical care 3.4 5.4 4.3 0.324 Could not afford prescription drugs 3.4 8.3 6.3 0.040 Could not afford to see a doctor 3.1 9.8 7.4 0.005 Table 3. Reported barriers to healthcare use.
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