title: Ecology of medical care in a publicly funded health care system: a registry study in Sweden.
abstract: OBJECTIVE
  To explore the influence of sociodemographic factors on access to appointments with physicians in primary, secondary, and tertiary health care in a publicly funded health care system.
  
  
  METHODS
  A population-based registry study.
  
  
  METHODS
  Different health care settings in Västernorrland county, Sweden.
  
  
  METHODS
  All residents in the county at the end of 2006.
  
  
  METHODS
  The number of people per 1000 residents who had at least one appointment with a physician in an average month in different health care settings.
  
  
  RESULTS
  A total of 87 people had appointments with a physician in primary health care, 44 in outpatient clinics at a regional hospital, 20 in an emergency department, 14 in home care, and two in a university hospital outpatient clinic. Twelve were hospitalized at a regional hospital and <1 at the university hospital. Being young or elderly, female, divorced, widowed, and having a contractor as usual source of care were all independently associated with higher odds of receiving primary care.
  
  
  CONCLUSIONS
  The physician's office in primary care is the setting that has the potential to affect the largest number of people. The extent of the use of health care was independently influenced by all sociodemographic characteristics studied, which highlights the importance of individual factors in future resource allocation. Regarding availability the ecology model provides superior information as compared with the absolute number of physicians' appointments. The prerequisites in Sweden of high-quality registries and unique personal identification numbers encourage future research on the ecology model to optimize accessibility of health care.
authors.affiliation: Research and Development, Sundsvall Hospital, Sundsvall, Sweden.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferro
authors.forename: Per M D
authors.initials: PM
authors.lastname: Kristiansson
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D002648:Child; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D017150:Public Sector; D012042:Registries; D040841:Resource Allocation / Q000191:economics; D012959:Socioeconomic Factors; D013548:Sweden