Unemployment and health care utilization

Objectives This study attempted to determine whether prior use of health se rvices predicts a subsequent risk of unemployment and also to describe the acute effects of exposure to unemployment on the use of health care service s. Material and methods The 1986 census records were linked with comprehensive health care information for the period 1983-1989 for over 44 629 randomly selected residents of Manitoba, Canada. All cause and cause-specific rates of hospital admission and ambulatory physician contacts were compared betwe en 1498 unemployed and 18 272 employed persons across 4 consecutive time pe riods related to the onset of unemployment. Results The adjusted rates of hospital admission and physician contacts wer e higher among the unemployed across all 4 periods. When persons with a his tory of mental health treatment were excluded, health care use in the perio d Drier to the onset of unemployment was equivalent: among the employed and unemployed. When a history of mental health treatment was controlled for, all-cause and cause-specific health care use was elevated among the unemplo yed during the unemployment spell. Conclusions Unemployed persons had increased hospitalization rates before t heir current spell of unemployment. Much of this difference was due to the subgroup with prior mental health treatment. For persons without prior ment al health care, hospitalization increased after a period of unemployment.