Canadian Journal of Public Health

, Volume 93, Issue 4, pp 303–307 | Cite as

Individual and Neighbourhood Determinants of Health Care Utilization

Implications for Health Policy and Resource Allocation
  • Alexandra M. Yip
  • George Kephart
  • Paul J. Veugelers


Objectives: To investigate the importance of both individual and neighbourhood socioeconomic characteristics for health care utilization.

Methods: Various linkage procedures generated a longitudinal dataset with information on 2,116 Nova Scotians, their residential neighbourhoods, 8 years of health care utilization and vital status. Unilevel and multilevel regression analyses were employed to examine the effects of both individual and neighbourhood characteristics on health care use.

Results: Individual income and education determined physician and hospital use. Also, neighbourhood characteristics, specifically average income and percentage of single mother families, were found to determine health care use. When considering individual and neighbourhood characteristics simultaneously, individual income and education determined physician and hospital use independently, while neighbourhood income determined physician use independently.

Conclusions: Both individual and neighbourhood socioeconomic characteristics determine health care use. Acknowledging this allows better targeting of health policy and planning, and enables more accurate needs-based resource allocation.


Objectif: Étudier l’importance des caractéristiques socio-économiques de particuliers et d’unités de voisinage dans l’utilisation des soins de santé.

Méthode: Par diverses méthodes de couplage, nous avons produit un ensemble de données longitudinales sur 2 116 Néo-Écossais, leurs unités de voisinage, leur statut vital et huit années d’utilisation des soins de santé. À l’aide d’analyses de régression à un et à plusieurs niveaux, nous avons examiné les effets des caractéristiques des particuliers et des unités de voisinage sur l’utilisation des soins de santé.

Résultats: Le revenu et la scolarité des particuliers déterminaient le recours aux médecins et aux hôpitaux. Certaines caractéristiques des unités de voisinage (le revenu moyen et le pourcentage de familles gynoparentales) déterminaient également l’utilisation des soins de santé. Lorsqu’on tient compte simultanément des caractéristiques des particuliers et des unités de voisinage, le revenu personnel et la scolarité déterminaient séparément le recours aux médecins et aux hôpitaux, tandis que le revenu de l’unité de voisinage déterminait séparément le recours aux médecins.

Conclusions: L’utilisation des soins de santé est déterminée par les caractéristiques socioéconomiques des particuliers et des unités de voisinage. Sachant cela, on pourra mieux cibler les politiques et la planification dans le domaine de la santé et effectuer avec plus de précision la répartition des ressources selon les besoins.


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Copyright information

© The Canadian Public Health Association 2002

Authors and Affiliations

  • Alexandra M. Yip
    • 1
  • George Kephart
    • 1
  • Paul J. Veugelers
    • 1
  1. 1.Department of Community Health and Epidemiology, Faculty of MedicineDalhousie UniversityHalifaxCanada

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