Department of Economics, College of Business, University of Louisville, Kentucky 40292, USA.
Med Care. 2010 Nov;48(11):1036-40. doi: 10.1097/MLR.0b013e3181eb31d2.
Compliance with preventive care recommendations differs between countries. Directly comparable data are often not available. The recent release of the Joint Canada/United States Survey of Health makes available data for both Canadians and Americans.
The health care systems in the United States and Canada differ quite dramatically. Canadians are covered by a universal health care system while residents of the United States, if they are insured, obtain their insurance from various private or public sources. This paper examines how the use of the Papanicolaou test (Pap smear) by women differs in the United States and Canada.
American women are more likely than Canadians to receive a pap smear. A Blinder/Oaxaca type decomposition is used to determine influence of observed population characteristics and unobserved differences between the 2 countries on this gap.
The decomposition shows that the gap in Pap smears between Canada and the United States is not influenced by observed demographic differences. Most of the difference is attributable to unobserved heterogeneity or how women are treated in the 2 systems.
Although Canada has universal health coverage, the use of Pap smears is lower than that of all US women and equal to that of uninsured US women. Most of the differences in use of Pap smears is the result of differences in unobserved heterogeneity or the way that the systems treat women which may be a function of differences between the 2 health care systems in marketing, delivering, and reimbursing care.
不同国家之间的预防保健建议的遵守情况存在差异。通常无法获得直接可比的数据。最近发布的加拿大/美国联合健康调查提供了加拿大人和美国人的数据。
美国和加拿大的医疗保健系统有很大的不同。加拿大人享有全民医疗保健系统，而美国人如果有保险，则从各种私人或公共来源获得保险。本文研究了妇女在加拿大和美国之间使用巴氏涂片（Pap 涂片）的情况有何不同。
美国女性比加拿大女性更有可能接受巴氏涂片检查。使用 Blinder/Oaxaca 类型的分解来确定观察到的人口特征和两个国家之间的未观察到的差异对这一差距的影响。
分解表明，加拿大和美国之间巴氏涂片检查的差距不受观察到的人口差异的影响。大部分差异归因于未观察到的异质性或两个系统对女性的治疗方式。
尽管加拿大拥有全民医疗保险，但巴氏涂片的使用率低于所有美国女性，与未参保的美国女性相当。巴氏涂片使用率的差异主要是由于未观察到的异质性或系统对待女性的方式不同，这可能是两个医疗保健系统在营销、提供和报销护理方面的差异所致。
