Patient Utilization of Specialists by Education and Income, Population-Weighted Canadian Community Health Survey, 2000–2001, for Ontario, and Ontario Health Insurance Plan Claims 2002–2004
| ≥1 Specialist Visit vs No Visita | ≥5 Specialist Visit vs <5 Visitsa | |||
|---|---|---|---|---|
| Patient Characteristic | Partially Adjusted OR (95% CI) | Fully Adjusted OR (95% CI) | Partially Adjusted OR (95% CI) | Fully Adjusted OR (95% CI) |
| CI=confidence interval; OR = odds ratio. | ||||
| aAdjusted for sociodemographic characteristics, self-reported morbidity, and diagnosis-based morbidity. | ||||
| bEducational attainment categorized as low (not completed high school), medium (high school completion and some postsecondary education), and high (university degree). Values missing for 0.7% of respondents. | ||||
| cIncome defined using total household income adjusted for the number of people living in the household and categorized as low (Statistics Canada’s lowest and lower-middle income), medium (upper-middle income), and high (highest income). For a household with 2 or fewer people, income levels correspond with Canadian dollar incomes of <$30,000, $30,000-59,999, and ≥$60,000, respectively. Values missing for 9.0% of respondents. | ||||
| CCHC measures | ||||
| Educational attainmentb | ||||
| High | 1.06 (0.93–1.18) | 1.22 (1.07–1.37) | 1.04 (0.88–1.19) | 1.23 (1.03–1.42) |
| Medium | 0.99 (0.87–1.12) | 1.12 (0.97–1.26) | 1.04 (0.86–1.22) | 1.19 (0.99–1.40) |
| Low (reference) | 1.00 | 1.00 | 1.00 | 1.00 |
| Incomec | ||||
| High | 0.98 (0.88–1.08) | 1.12 (0.99–1.24) | 0.88 (0.76–1.00) | 1.05 (0.90–1.20) |
| Medium | 0.95 (0.85–1.05) | 1.02 (0.90–1.13) | 1.00 (0.86–1.13) | 1.12 (0.96–1.29) |
| Low (reference) | 1.00 | 1.00 | 1.00 | 1.00 |
| Location | ||||
| Urban | 1.29 (1.16–1.41) | 1.22 (1.10–1.34) | 1.22 (1.07–1.37) | 1.19 (1.03–1.34) |
| Rural (reference) | 1.00 | 1.00 | 1.00 | 1.00 |
| Age (continuous) | 1.04 (1.04–1.04) | 1.03 (1.02–1.03) | 1.04 (1.03–1.04) | 1.03 (1.02–1.03) |
| Sex | ||||
| Female | 1.55 (1.42–1.67) | 1.21 (1.10–1.31) | 1.18 (1.04–1.32) | 1.04 (0.90–1.17) |
| Male (reference) | 1.00 | 1.00 | 1.00 | 1.00 |
| Self-rated health | ||||
| Fair-poor | — | 1.24 (1.05–1.43) | — | 1.66 (1.37–1.95) |
| Good | — | 1.12 (1.00–1.24) | — | 1.24 (1.06–1.42) |
| Very good/excellent (reference) | — | 1.00 | — | 1.00 |
| Chronic conditions ≥2 | ||||
| Yes | — | 1.32 (1.19–1.45) | — | 1.12 (0.97–1.26) |
| No (reference) | — | 1.00 | — | 1.00 |
| Depression | ||||
| Yes | — | 1.08 (0.92–1.24) | — | 1.08 (0.90–1.25) |
| No (reference) | — | 1.00 | — | 1.00 |
| Disability | ||||
| Yes | — | 1.15 (0.98–1.33) | — | 1.15 (0.97–1.33) |
| No (reference) | — | 1.00 | — | 1.00 |
| Adjusted Clinical Groups | ||||
| Aggregated diagnosis groups | ||||
| ≥10 (high) | — | 3.02 (2.17–3.87) | — | 2.34 (1.76–2.92) |
| 6–9 (medium) | — | 1.89 (1.67–2.10) | — | 1.37 (1.18–1.56) |
| 0–5 (low) (reference) | — | 1.00 | — | 1.00 |
| Resource utilization bands | ||||
| ≥4 (very high) | — | 3.31 (2.53–4.10) | — | 2.76 (1.85–3.68) |
| 3 (high) | — | 2.79 (2.38–3.21) | — | 1.85 (1.36–2.33) |
| 2 (medium) | — | 1.71 (1.44–1.98) | — | 1.22 (0.88–1.57) |
| 0–1 (low) (reference) | — | 1.00 | — | 1.00 |