Socio-economic status and visits to physicians by adults in Ontario, Canada

Objectives — To examine the association between socio-economic status, need for medical care and visits to physicians in a universal health insurance system.

Methods — Cross-sectional analysis of the 1990 Ontario Health Survey, a population-based survey utilizing a multi-stage, randomized cluster sample. The analysis considered only those respondents who were 16 years of age or older from the province of Ontario, Canada: 21,272 males and 24,738 females.

Results — There was no difference by education or income in persons having made at least one visit to a general practitioner in the previous year. High income persons were less likely to have made six or more visits to a general practitioner—odds ratio (OR) = 0.67, 95% CI = 0.52, 0.87 for men; OR = 0.66, 95% CI = 0.58, 0.75 for women—but more likely to have made at least one visit to a specialist—OR = 1.42, 95% CI = 1.15, 1.76 for men; OR = 1.25, 95% CI = 1.07, 1.45 for women. A person's need for medical care was the most important determinant of a physician visit.

Conclusions — Self-reported visits to general practitioners in Canada are strongly influenced by a person's need for medical care and are appropriately related to socio-economic status. However, there is a residual association between higher socio-economic levels and greater use of specialist services.