Health care utilization in Canada: Twenty-five years of evidence

A plethora of literature links socioeconomic status (SES) to health and health care utilization. Recent anecdotal evidence indicates that Canadians believe their access to health care is diminishing. This study describes health care utilization patterns for services provided under public health insurance (physicians, specialists, and hospitals) in Canada between 1978 and 2003. The relationship between SES and utilization, controlling for health and demographic characteristics, is examined to investigate whether changes in the equity of utilization have occurred over time. Results indicate that SES inequities in utilization are apparent, appearing to be more relevant in initial contact with the system than in the number of visits. Specialists' services are particularly problematic and becoming more so over time.