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Canadian Journal of Public Health

, Volume 100, Issue 3, pp 180–183 | Cite as

High Health Care Utilization and Costs Associated with Lower Socio-economic Status: Results from a Linked Dataset

  • Mark Lemstra
  • Johan Mackenbach
  • Cory Neudorf
  • Ushasri Nannapaneni
Quantitative Research

Abstract

Objective

The purpose of this paper was to use a linked dataset to compare health care utilization rates and costs between income groups in Saskatoon, Canada.

Methods

The Canadian Community Health Survey was linked to hospital, physician and medication data in Saskatoon.

Results

Of 3,688 eligible participants, 3,433 agreed to the health survey and data linkage with health records (83.7% overall response). Low-income residents were 27–33% more likely to be hospitalized and 36–45% more likely to receive a medication than middle- and higher-income residents, but were 5–7% less likely to visit a physician over a one-year period. In comparison to middle-income residents, low-income residents had 56% more high users of hospitals, 166% more high users of physicians and 90% more high users of medications. Low-income residents had 34–35% higher health care costs overall than middle- and high-income residents. After multivariate adjustment for increased disease prevalence, low income had a reduced association with high health care utilization.

Conclusions

The results demonstrate that residents with lower income are responsible for disproportionate usage of hospitals, physicians and medications; due mainly (but not entirely) to higher disease prevalence.

Key words

Delivery of health care utilization socioeconomic factors economics 

Résumé

Objectif

Utiliser un ensemble de données interreliées pour comparer les taux et les coûts d’utilisation des soins de santé entre différentes catégories de revenu à Saskatoon, Canada.

Méthodes

Les données de l’Enquête sur la santé dans les collectivités canadiennes ont été reliées à celles de la base de données sur les hôpitaux, les médecins et les médicaments de Saskatoon.

Résultats

Des 3 688 participants admissibles, 3 433 ont accepté qu’un lien soit créé entre les données de l’Enquête et celles de leur dossier médical (taux de réponse de 83,7 %). Les résidents à faible revenu ont de 27 à 33 % plus de chances d’être hospitalisés et de 36 à 45 % plus de chances de recevoir un médicament que les résidents à revenu moyen et élevé, mais de 5 à 7 % moins de chances de consulter un médecin une fois par année. Comparativement aux résidents à revenu moyen, les résidents à faible revenu comptent 56 % plus d’utilisateurs d’hôpitaux, 166 % plus d’utilisateurs de services médicaux (médecins), et 90 % plus d’utilisateurs de médicaments. Chez les résidents à faible revenu, les coûts des soins de santé étaient de 34 à 35 % plus élevés que chez les résidents à revenu moyen et élevé. Après avoir effectué les corrections multidimensionnelles de l’augmentation du taux de prévalence de maladie, les résidents à faible revenu démontrent une association réduite avec l’utilisation fréquente des soins de santé.

Conclusions

Les résultats démontrent que les résidents à faible revenu utilisent de façon disproportionnée les hôpitaux, les médecins et les médicaments, et ce, principalement (mais non entièrement) en raison d’un taux plus élevé de prévalence de maladie.

Mots clés

prestation de soins de santé utilisation facteurs socioéconomiques économie 

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Copyright information

© The Canadian Public Health Association 2009

Authors and Affiliations

  • Mark Lemstra
    • 1
  • Johan Mackenbach
    • 2
  • Cory Neudorf
    • 1
  • Ushasri Nannapaneni
    • 1
  1. 1.Saskatoon Health RegionSaskatoonCanada
  2. 2.Erasmus UniversityNetherlandsCanada

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