Equity in Healthcare Utilization in Canada: 2000-2014

Abstract

Equity in healthcare utilization is a globally accepted measurement of the effectiveness of a healthcare system. Equity is included as a policy goal in the federal health legislation that governs healthcare systems in Canada. This study used ten cycles of the Statistics Canada Canadian Community Health Survey (CCHS) to examine the income-related equity of healthcare utilization in Canada from 2000 to 2014. The horizontal inequity (HI) index was used to quantify and assess trends in the equity in healthcare utilization for general practitioner (GP) visits, specialist physician (SP) visits and hospital admissions (HA) nationally, in urban and rural areas, and for all provinces. Nationally, GP and SP visits show pro-rich inequity, while HA demonstrates pro-poor inequity. This pattern is consistent in the provincial and urban and rural area results. Trend analysis demonstrates inequality of HA use became less pro-poor from 2000 to 2014, while inequity of GP use became more pro-poor in New Brunswick, but more pro-rich in Prince Edward Island and Quebec. All other trends indicate that inequity of healthcare utilization was consistently present from 2000 to 2014. These results demonstrate that despite the inclusion of equity as a policy goal, inequity of utilization remains a persistent issue in the Canadian healthcare system.