International comparison of health resource utilization in subjects with diabetes: an analysis of Canadian and American national health surveys.
OBJECTIVE
To compare health resource utilization in patients with diabetes between the U.S. and Canada.


METHODS
We combined measures of health care utilization, personal, demographic, health status, functional status, and comorbid conditions from the current National Health Interview Survey (U.S.) and the National Public Health Survey (Canada). A binary logistic regression analysis was used to examine how country of residence influences the probability of accessing health care resources in adult Caucasian subjects after controlling for potential confounders.


RESULTS
Subjects from Canada (n = 521) were more likely to have contact with a general physician (odds ratio [OR] 4.01, 95% CI 2.26-7.14), eye specialists (1.46, 1.08-1. 98), and any physician (3.02, 1.03-8.84) in the past year than their American counterparts (n = 825) but were less likely to have had contact with other medical specialists (0.33, 0.24-0.46). Subjects in Canada were also more likely to have been hospitalized overnight (1.79, 1.17-2.75) or to have contact with a health care professional in the previous 12 months (3.35, 1.01-12.81).


CONCLUSIONS
Significant disparities exist in health service utilization for adult Caucasian individuals with diabetes in Canada versus the U.S. after controlling for various confounders. From what is known regarding optimal treatment of diabetes, those with diabetes in the U.S. have a greater chance of not receiving recommended care.
Klarenbach
Scott W
SW
University of Alberta, Alberta, Canada. swk@ualberta.ca
Jacobs
Philip
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003710:Demography; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States