[Low income and number of contacts with general practice].
BACKGROUND
The purpose of this study was to examine whether there are differences in the use of general practice between citizens in low income groups and citizens with higher income after adjustment for social and health-related factors.


METHODS
Registers from Statistics Denmark on adult citizens of Odense Municipality in 2005 were used. Income was measured as annual equivalent disposable income and adjustment for social and health-related personal characteristics was performed using Poisson regression.


RESULTS
Poor adults with income below 73,000 DKK have 2-3 fewer contacts with general practice annually than those with an income of 73,000-146,000 DKK, while adults with an income above 292,000 DKK have the lowest utilization of general practice of any group. The difference between the poor and those with low income was reduced to 1.5 fewer contacts after adjustment for social and health-related characteristics and further to 1,1 when a sizeable unidentified socio-economic group was omitted.


CONCLUSIONS
Poor adults have significantly fewer contacts with general practice than adults with low or middle income. This contrasts with results from earlier studies and may be an indication of underutilization of general practice. Other explanations may be that poor citizens enter the primary health sector through other channels or that the type and quality of contacts vary between income groups, that adjustment for health or other need indicators are insufficient. Furthermore, data shortcomings such as lack of information on non-taxed income and non-taxable assets may also serve as alternative explanations.
Arendt
Jacob Nielsen
JN
Syddansk Universitet, institut for Sundhedstjenesteforskning, Forskningsenheden for Sundhedsokonomi og Center for Anvendt Sundhedstjensteforskning, Odense, Denmark. jna@sam.sdu.dk
Jensen
Britt Toftgaard
BT
Nexøe
Jørgen
J
Müntzberg
Gert
G
Sørensen
Jan
J
D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology / Q000208:ethnology; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012042:Registries; D012959:Socioeconomic Factors; D055815:Young Adult