The Use of Physician Services Under a National Health Insurance Scheme

Broyles, Robert W.; Manga, Pran; Binder, David A.; Angus, Douglas E; Charette, André.

doi:10.1097/00005650-198311000-00001

Cited by 37 publications

(19 citation statements)

References 20 publications

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“…While most conclude that there is no association between income and incidence of GP utilization when assessed over a 1-year period (Broyles et al 1983;Birch, Eyles, and Newbold 1993;McIsaac, Goel, and Naylor 1997;Dunlop, Coyte, and McIsaac 2000;Finkelstein 2001), the association between income and volume of GP utilization is less clear. Several studies have reported an inverse association even after adjustment for need (Broyles et al 1983;McIsaac, Goel, and Naylor 1997;Dunlop, Coyte, and McIsaac 2000), while others have reported no differential utilization by income level (Birch, Eyles, and Newbold 1993;Finkelstein 2001). In general, most studies that were unable to use direct measures to control for medical need found an expected inverse association between income and utilization of GP services Kephart, Thomas, and MacLean 1998;Veugelers and Yip 2003); however, a recent study by Roos et al (2004) observed lower than expected use of physician services among individuals from poorer neighborhoods.…”

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confidence: 99%

“…It has been suggested that opportunity costs associated with attending medical appointments may render some individuals less likely to access care than others (Broyles et al 1983;Birch, Eyles, and Newbold 1993). There are reasons to believe that employment-related opportunity costs may influence an individual's ability to access GP services.…”

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confidence: 99%

“…Because the ability to attend ambulatory medical appointments is time dependent, ''time crunch'' imposed by work may operate as a barrier to utilization (Boaz and Muller 1989) in that it reduces opportunities to access medical appointments (Nishiyama and Johnson 1997). Lost wages for time off work may also deter some workers from accessing care (Broyles et al 1983;Boaz and Muller 1989).…”

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confidence: 99%

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The Relationship between Work Hours and Utilization of General Practitioners in Four Canadian Provinces

Fell

Kephart

Curtis

et al. 2007

Health Services Research

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Objective. To assess whether long work hours act as a barrier to accessing general practitioner (GP) services. Data Sources. Secondary data from the 1996/1997 National Population Health Survey (NPHS) and administrative health services utilization data from four Canadian provinces. Study Design. This study was cross-sectional, however, employment variables and GP utilization were reflective of the 12-month period preceding the NPHS interview date. Negative binomial regression was used to model the relationship between the number of GP visits in a 1-year period and employment-related variables while adjusting for other determinants of GP utilization including education, income, and health status. Data Extraction Methods. NPHS and administrative data were linked to create an analysis file. Principal Findings. Subjects with long, standard work hours (445 hours/week, with most hours during the day) had significantly lower GP utilization rates compared with full-time workers. White-collar workers with long work hours visited a GP significantly less often than white-collar workers with regular hours. Conclusions. Long work hours may act as a nonfinancial barrier to accessing GP services independent of health status.

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confidence: 99%

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confidence: 99%

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The Relationship between Work Hours and Utilization of General Practitioners in Four Canadian Provinces

Fell

Kephart

Curtis

et al. 2007

Health Services Research

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“…L'introduction de l'assurance-maladie, par exemple, a amélioré l'accès des couches sociales inférieures aux services médicaux (ENTERLINE,1973;MCDONALD, 1974). Contrairement aux États-Unis (BROYLES, 1983;MANGA, 1987), le revenu n'est plus, au Québec, un déterminant important de l'utilisation des services médicaux et hospitaliers.…”

Section: Les Déterminants De La Prise De Décision Pubuqueunclassified

Gestion publique du système sociosanitaire : où allons nous?

Bozzini¹,

Soderstrom²

2008

nps

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Résumé L'actuel processus de décision concernant les choix politiques en matière sociosanitaire repose sur un déficit d'information : il est difficile pour l'État de savoir s'il dépense trop en soins de santé et si les dépenses sont bien contrôlées. La centralisation excessive accroît la gravité de ce déficit informationnel. La réforme législative veut obvier à cette difficulté en décentralisant au niveau régional : cependant, le Ministère se réserve des pouvoirs très importants. Il est à se demander si les régions pourront résister aux pressions du centre et si elles ne sont pas victimes du même manque d'informations.

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“…Several Canadian studies have examined the socioeconomic differences in use of physician services, yielding mixed results. However, the results have generally shown that the introduction of universal medicare resulted in increased use of health services by persons in lower-income households and that there is now an inverse association between income and use of health [5][6][7][8][9][10][11][12][13][14] services.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic differences in the use of physician services in Nova Scotia.

Kephart

Thomas²,

MacLean³

1998

Am J Public Health

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OBJECTIVES: Socioeconomic differences in use of physician services in Nova Scotia, Canada were examined. METHODS: The study was based on survey data, containing information on socioeconomic status, linked to physician claims data. Socioeconomic differences in use of physician services were estimated, adjusted for age, sex, and region of residence. RESULTS: Large socioeconomic differences were observed in the use of physician services, with use inversely related to both household income and education. These differences remained after adjustment for age, sex, and region. CONCLUSIONS: Use of physician services is inversely associated with socioeconomic status.

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The Use of Physician Services Under a National Health Insurance Scheme

Cited by 37 publications

References 20 publications

The Relationship between Work Hours and Utilization of General Practitioners in Four Canadian Provinces

The Relationship between Work Hours and Utilization of General Practitioners in Four Canadian Provinces

Gestion publique du système sociosanitaire : où allons nous?

Socioeconomic differences in the use of physician services in Nova Scotia.

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