Quan Hude, Fong Andrew, De Coster Carolyn, Wang Jianli, Musto Richard, Noseworthy Tom W, Ghali William A
Department of Community Health Sciences and The Centre for Health and Policy Studies, University of Calgary, Calgary, Alta.
CMAJ. 2006 Mar 14;174(6):787-91. doi: 10.1503/cmaj.050674.
Although racial and ethnic disparities in health services utilization and outcomes have been extensively studied in several countries, this issue has received little attention in Canada. We therefore analyzed data from the 2001 Canadian Community Health Survey to compare the use of health services by members of visible minority groups and nonmembers (white people) in Canada.
Logistic regression was used to compare physician contacts and hospital admissions during the 12 months before the survey and recent cancer screening tests. Explanatory variables recorded from the survey included visible minority status, sociodemographic factors and health measures.
Respondents included 7057 members of visible minorities and 114,255 white people for analysis. After adjustments for sociodemographic and health characteristics, we found that minority members were more likely than white people to have had contact with a general practitioner (adjusted odds ratio [OR] 1.28, 95% confidence interval [CI] 1.14-1.42), but not specialist physicians (OR 1.01, 95% CI 0.93-1.10). Members of visible minorities were less likely to have been admitted to hospital (OR 0.83, 95% CI 0.70- 0.98), tested for prostate-specific antigen (OR 0.64, 95% CI 0.52-0.79), administered a mammogram (OR 0.68, 95% CI 0.59-0.80) or given a Pap test (OR 0.47, 95% CI 0.39-0.56).
Use of health services in Canada varies considerably by ethnicity according to type of service. Although there is no evidence that members of visible minorities use general physician and specialist services less often than white people, their utilization of hospital and cancer screening services is significantly less.
尽管在几个国家对卫生服务利用和结果方面的种族和族裔差异进行了广泛研究，但这个问题在加拿大却很少受到关注。因此，我们分析了2001年加拿大社区健康调查的数据，以比较加拿大少数族裔群体成员和非少数族裔群体成员（白人）对卫生服务的利用情况。
采用逻辑回归比较调查前12个月内的医生诊疗接触和住院情况以及近期癌症筛查检测。从调查中记录的解释变量包括少数族裔身份、社会人口统计学因素和健康指标。
纳入分析的受访者包括7057名少数族裔成员和114255名白人。在对社会人口统计学和健康特征进行调整后，我们发现少数族裔成员比白人更有可能与全科医生有过接触（调整后的优势比[OR]为1.28，95%置信区间[CI]为1.14 - 1.42），但与专科医生接触的可能性没有差异（OR为1.01，95% CI为0.93 - 1.10）。少数族裔成员住院的可能性较小（OR为0.83，95% CI为0.70 - 0.98），接受前列腺特异性抗原检测的可能性较小（OR为0.64，95% CI为0.52 - 0.79），接受乳房X光检查的可能性较小（OR为0.68，95% CI为0.59 - 0.80）或接受巴氏试验的可能性较小（OR为0.47，95% CI为0.39 - 0.56）。
在加拿大，卫生服务的利用因族裔和服务类型而有很大差异。虽然没有证据表明少数族裔成员比白人更少使用全科医生和专科医生服务，但他们对医院和癌症筛查服务的利用率明显较低。
