Higher income earners more likely to get doctors' appointments than lower income people

People of high socioeconomic status are more likely to be able to access primary care than those of low socioeconomic status, even within a universal health care system in which physicians are reimbursed equally for each patient, found an article published in CMAJ (Canadian Medical Association Journal).

"A person calling a physician's office and asking to be seen as a new primary care patient was more than 50% more likely to be given an appointment if he or she presented as being of high ," says senior author Dr. Stephen Hwang from the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Department of Medicine, University of Toronto. "Because we see this finding in a single-payer universal health insurance system, it provides evidence of discrimination by physicians' offices on the basis of socioeconomic status."

Researchers undertook a randomized controlled audit study to determine whether socioeconomic status as well as health status affected a potential patient's ability to secure an appointment with a primary care physician. They telephoned 568 family physician and offices in Toronto, Ontario, Canada, posing as a bank employee (someone of high socioeconomic status) and a welfare recipient () with chronic health conditions (diabetes and back pain) or no major conditions. Final data were available from 375 offices; most responses were from administrative staff.

Canada has a universal in which all patients may receive care, because health care fees are paid through a third party. Inability to pay is not a barrier to care as in some countries where users pay for health care. However, about 15% of Canadians do not have a regular medical doctor; a key reason is that physicians are not accepting new patients.

In this study, people of high socioeconomic status were more likely than people of low socioeconomic status to receive an appointment offer (23% v. 14%) or an offer of an appointment, screening visit or place on a waiting list (37% v. 24%). On the positive side, people with chronic health conditions were more likely to receive appointment offers than people without these conditions (24% v. 13%).

"Although it is reassuring that patients with received prioritized access to primary care, our results suggest a need for greater efforts to ensure that physicians and their office staff do not discriminate against people of low socioeconomic status," state the authors.

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.121383

add to favorites email to friend print save as pdf

Related Stories

Childhood socioeconomic status affects brain volume

Apr 27, 2012

(HealthDay) -- Childhood socioeconomic status affects hippocampal volume in older adults, after adjusting for adult socioeconomic status, gender, education, and other factors, according to a study published ...

Recommended for you

Before you go... are you in denial about death?

41 minutes ago

For most of us, death conjures up strong feelings. We project all kinds of fears onto it. We worry about it, dismiss it, laugh it off, push it aside or don't think about it at all. Until we have to. Of course, ...

UK court to rule on landmark 'pregnancy crime' case

2 hours ago

A British court is to rule on whether a woman committed a "crime of violence" against her child by drinking heavily during pregnancy, in a case that has raised concerns about criminalising mothers.

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

Czulu
not rated yet Feb 25, 2013
hate to say this way, but Duh
Czulu
not rated yet Feb 25, 2013
Even in KY if you are poor you have to wait till paying persons get seen, Before they will even see you.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.