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The relationship between occupation, work patterns and utilization of general practitioners in four Canadian provinces.

机译:加拿大四个省的职业,工作模式与全科医生的利用之间的关系。

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摘要

Canada's health care system is generally seen to be equitable to the degree that access to care is not dependent upon ability to pay. Despite the lack of direct cost to the consumer, there may still be non-financial barriers to access. This study assessed the degree to which occupation and work patterns may act as non-financial barriers to accessing general practitioner (GP) services.; Data from the 1996/97 cross-sectional wave of the National Population Health Survey were linked to administrative data from provincial Medicare databases in Nova Scotia, Manitoba, Saskatchewan and British Columbia. Negative binomial regression was used to evaluate the impact of occupation and work patterns on volume of GP services consumed in a one-year period, adjusted for other determinants of health care utilization.; The relationship between occupation, work patterns and utilization of GP services was strongly determined by regional context. In weighted analyses, which favored the province of British Columbia, no evidence of an adjusted relationship between occupation, work patterns and GP utilization was found. In unweighted analyses however, individuals who worked long hours (greater than 45 hours per week) had significantly fewer GP visits during the study year compared to part-time workers. While occupation alone did not have a significant relationship with GP utilization after adjustment for other determinants of utilization, when combined with the number of working hours, white-collar workers with long hours visited a GP significantly less often than workers with regular hours. Health status variables were consistently among the strongest predictors of GP utilization. Household income was not associated with adjusted GP utilization.; This study provides the first known empirical evidence that long working hours is associated with reduced utilization of GP services. This finding should be further investigated in a larger study that can support stratification by province in order to better assess regional effects.
机译:人们普遍认为加拿大的医疗体系在某种程度上是公平的,即获得医疗服务并不取决于支付能力。尽管没有给消费者带来直接成本,但获取渠道仍可能存在非经济障碍。这项研究评估了职业和工作模式可能在多大程度上成为获得全科医生服务的非财务障碍。 1996/97年全国人口健康调查横断面波的数据与新斯科舍省,曼尼托巴省,萨斯喀彻温省和不列颠哥伦比亚省的医疗保险数据库中的行政数据相关联。二项式负回归被用来评估职业和工作方式对一年内所消费的全科医生服务量的影响,并根据其他决定医疗保健利用的因素进行了调整。 GP的职业,工作模式和利用之间的关系在很大程度上取决于地区情况。在偏爱不列颠哥伦比亚省的加权分析中,没有发现职业,工作模式和全科医生使用之间的调整关系的证据。然而,在非加权分析中,与非全日制工作人员相比,长时间工作(每周大于45小时)的个人在本研究年度内的GP就诊次数显着减少。调整其他使用率决定因素后,单单职业与全科医生使用率没有显着关系,但结合工作时间数量,长时间工作的白领工人访问全科医生的频率显着低于正常工作人员。健康状况变量始终是GP利用率的最强预测指标。家庭收入与调整后的全科医生利用率无关。这项研究提供了第一个已知的经验证据,即长时间工作与降低GP服务的使用率有关。为了更好地评估区域效应,应该在更大的研究中进一步调查该发现,该研究可以支持各省的分层。

著录项

  • 作者

    Fell, Deshayne Blayre.;

  • 作者单位

    Dalhousie University (Canada).;

  • 授予单位 Dalhousie University (Canada).;
  • 学科 Health Sciences Public Health.; Health Sciences Medicine and Surgery.
  • 学位 M.Sc.
  • 年度 2002
  • 页码 72 p.
  • 总页数 72
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;
  • 关键词

  • 入库时间 2022-08-17 11:46:18

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