PHYSICIAN USE IN ONTARIO AND THE UNITED-STATES - THE IMPACT OF SOCIOECONOMIC-STATUS AND HEALTH-STATUS

Objectives. This study compared physician use in Ontario and the midwe stern and northeastern United States for persons of different socioeco nomic status and health status. The distribution of health problems as sociated with the most recent physician visit also was compared. Metho ds. The design of the study was cross sectional; data derived from the 1990 Ontario Health Survey and the 1990 US National Health Interview Survey were used in analyses. Results. Overall, persons in Ontario ave raged 19% more visits than US residents, but differences varied marked ly across income and health status. At each level of health status, lo w-income Canadians had 25% to 33% more visits than their US counterpar ts. However. among higher income persons. those in excellent or very g ood health had 22% more visits than Americans, while those in good, fa ir, or poor health had 10% fewer visits than Americans. Higher visit r ates in Ontario were not associated with a greater prevalence of low-p riority visits. Conclusions. Under the Canadian single-payer system, m edical care in Ontario has been redistributed to low-income persons an d the elderly, Compared with tile United States, there has been a lowe r intensity of medical care for the sick higher income population.