Overview

Abstract (English)

This paper asks if the general population, asthmatics, and diabetics in Ontario, Canada, experience the same income related inequities in the use of physician services. The paper then goes on to decompose the inequalities into the different contributing factors. This paper makes two contributions to the literature using the concentration index approach by being one of the first study to: (i) use linked administrative-survey data to measure income-related inequalities in physician use; and (ii) combine the condition specific approach with the population-based approach. Results for the general population are consistent with the previous literature: no income-related inequity in the probability of GP use; pro-poor income-related inequity in GP use (conditional on having any use), and a slight pro-rich income-related inequity in the probability and conditional use of specialists. Differences are found between the general population and the condition specific groups, but similar income-related inequities between asthmatics and diabetics. All three groups show more pro-poor inequity in conditional GP use for asthmatics than for the general population, and even more for diabetics than asthmatics. The general population shows pro-rich income-related inequity in the probability of specialist use, while asthmatics show no income-related inequity in the probability of specialist use and diabetics show a slight pro-rich inequity in the probability of specialist use. The general population shows a slight pro-rich inequity in the conditional use of specialists, while asthmatics and diabetics show no income-related inequity in the use of specialists. The decomposition analysis shows is the largest contributor to inequality of physician use among all groups

Abstract (French)

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