Income and Regional Gradients in Being without a Regular Doctor: Does the Slope of Gradients Decrease for Those with Greater Health Needs?

摘要

Objective: Income and regional gradients in being without a regular family doctor have been reported. The study objective was to assess the extent to which the slopes of both income and regional gradients vary by individuals' health needs. Method: Using the Canadian Community Health Survey and multivariate regression analyses, the study examined the income and interprovincial variations in potential access among the healthy and less healthy populations. Results: The presence of chronic conditions was associated with lower variations in income-related potential access, with the income gradient flattening at the second-lowest income category. Similarly, the presence of two or more chronic conditions flattened interprovincial variations in potential access. Conclusions: The results suggest a greater equity in having a regular doctor on the basis of need. Systemic changes might be needed to enhance potential access among the vulnerable segment of the population.