Hospital utilization in Ontario and the United States: the impact of socioeconomic status and health status.
We compared hospital use in Ontario and the United States for persons with different socioeconomic and health status.


METHODS
Cross-sectional study using the 1990 Ontario Health Survey and the 1990 National Health Interview Survey.


RESULTS
Admission rates averaged 31% higher in Ontario than in the United States, but international differences varied markedly across income and health status. At each level of health status, poor Canadians received one quarter to one third more admissions than their counterparts in the United States. However, higher income Canadians reporting excellent to good health had 50% more admissions than Americans, whereas those reporting fair or poor health had 10% fewer admissions.


CONCLUSIONS
The observation that higher income sick persons receive less hospital care in Ontario than in the U.S. provides support at the population level for what has been observed for specific technologies. This represents, in part, a redistribution of inpatient care to those most vulnerable to illness, such as the poor, who receive substantially more hospital care in Ontario.
Katz
S J
SJ
Department of Internal Medicine and Health Management and Policy, University of Michigan, Ann Arbor 48109-0376, USA.
Hofer
T P
TP
Manning
W G
WG
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics*; D006304:Health Status; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States