ArticleAnnals of family medicine
Universal health insurance and equity in primary care and specialist office visits: a population-based study.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review.International journal for equity in health · 2021Pooled it
- Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes.Canadian family physician Medecin de famille canadien · 2019Guideline
- Predictors of exercise participation among Saudi adults attending primary healthcare centers in Riyadh.Scientific reports · 2026Article
- Waiting time to see a dermatologist in South Africa: A cross-sectional survey.Journal of the colleges of medicine of South Africa · 2026Article
- Educational differences in cancer incidence, stage at time of diagnosis, and survival in Norway.Research in health services & regions · 2025Article
- Collecting sociodemographic data in primary care: qualitative interviews in community health centres.BJGP open · 2025Article
- A Retrospective Analysis of Universal Health Insurance Policy-Making Process in Iran: A Qualitative Study.Health science reports · 2024Article
- Article
- Educational differences in healthcare use among survivors after breast, prostate, lung, and colon cancer - a SEQUEL cohort study.BMC health services research · 2023Article
- Do changes in primary care service use over time differ by neighbourhood income? Population-based longitudinal study in British Columbia, Canada.International journal for equity in health · 2022Article
- Article
- Exploring social inequalities in healthcare trajectories following diagnosis of diabetes: a state sequence analysis of linked survey and administrative data.BMC health services research · 2022Article
- A systematic review of risk stratification tools internationally used in primary care settings.Health science reports · 2021Review
- Rheumatologists' Acceptance of Patient Referrals from Physical Therapists.Healthcare policy = Politiques de sante · 2020Article
- Resolution, access, and waiting time for specialties in different models of care.Revista de saude publica · 2020Article
- Review
- Prevalence and determinants of self referrals to a District-Regional Hospital in KwaZulu Natal, South Africa: a cross sectional study.The Pan African medical journal · 2019Article
- Equity of primary care service delivery for low income "sicker" adults across 10 OECD countries.International journal for equity in health · 2018Article
- Socioeconomic status and anterior epistaxis in adult population.World journal of otorhinolaryngology - head and neck surgery · 2018Article
- The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUniversal coverage of physician services should serve to reduce socioeconomic disparities in care, but the degree to which a reduction occurs is unclear. We examined equity in use of physician services in Ontario, Canada, after controlling for health status using both self-reported and diagnosis-based measures.
methodsOntario respondents to the 2000-2001 Canadian Community Health Survey (CCHS) were linked with physician claim files in 2002-2003 and 2003-2004. Educational attainment and income were based on self-report. The CCHS was used for self-reported health status and Johns Hopkins Adjusted Clinical Groups was used for diagnosis-based health status.
resultsAfter adjustment, higher education was not associated with at least 1 primary care visit (odds ratio [OR] = 1.05; 95% confidence interval [CI], 0.87-1.24), but it was inversely associated with frequent visits (OR = 0.77; 95% CI, 0.65-0.88). Higher education was directly associated with at least 1 specialist visit (OR = 1.20; 95% CI, 1.07-1.34), with frequent specialist visits (OR = 1.21; 95% CI, 1.03-1.39), and with bypassing primary care to reach specialists (OR = 1.23, 95% CI 1.02-1.44). The largest inequities by education were found for dermatology and ophthalmology. Income was not independently associated with inequities in physician contact or frequency of visits.
conclusionsAfter adjusting for health status, we found equity in contact with primary care for educational attainment but inequity in specialist contact, frequent visits, and bypassing primary care. In this setting, universal health insurance appears to be successful in achieving income equity in physician visits. This strategy alone does not eliminate education-related gradients in specialist care.
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