Socio-economic status and visits to physicians by adults in Ontario, Canada.
OBJECTIVE
To examine the association between socio-economic status, need for medical care and visits to physicians in a universal health insurance system.


METHODS
Cross-sectional analysis of the 1990 Ontario Health Survey, a population-based survey utilizing a multi-stage, randomized cluster sample. The analysis considered only those respondents who were 16 years of age or older from the province of Ontario, Canada: 21,272 males and 24,738 females.


RESULTS
There was no difference by education or income in persons having made at least one visit to a general practitioner in the previous year. High income persons were less likely to have made six or more visits to a general practitioner--odds ratio (OR) = 0.67, 95% CI = 0.52, 0.87 for men; OR = 0.66, 95% CI = 0.58, 0.75 for women--but more likely to have made at least one visit to a specialist--OR = 1.42, 95% CI = 1.15, 1.76 for men; OR = 1.25, 95% CI = 1.07, 1.45 for women. A person's need for medical care was the most important determinant of a physician visit.


CONCLUSIONS
Self-reported visits to general practitioners in Canada are strongly influenced by a person's need for medical care and are appropriately related to socio-economic status. However, there is a residual association between higher socio-economic levels and greater use of specialist services.
McIsaac
W
W
Department of Family and Community Medicine, Mt Sinai Hospital, University of Toronto.
Goel
V
V
Naylor
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009864:Ontario / Q000453:epidemiology; D012923:Social Class; D013038:Specialization; D011795:Surveys and Questionnaires; D014600:Utilization Review