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加拿大有和没有固定医生的人群的医疗服务利用情况。

Health services utilization of people having and not having a regular doctor in Canada.

作者信息

Thanh Nguyen Xuan, Rapoport John

机构信息

Institute of Health Economics, Edmonton, Alberta, Canada.

Mount Holyoke College, South Hadley, Massachusetts, USA.

出版信息

Int J Health Plann Manage. 2017 Apr;32(2):180-188. doi: 10.1002/hpm.2338. Epub 2016 Feb 10.

Abstract

Canada having a universal health insurance plan that provides hospital and physician benefits offers a natural experiment of whether continuity of care actually provides lower or higher utilization of services. The question we are evaluating is whether Canadians, who have a regular physician, use more health resources than those who do not have one? Using two statistical methods, including propensity score matching and zero-inflated negative binomial regression, we analyzed data from the 2010 and 2007/2008 Canadian Community Health Surveys separately to document differences between people self-reportedly having and not having a regular doctor in the utilization of general practitioner, specialist, and hospital services. The results showed, consistently for all two statistical methods and two datasets used, that people reportedly having a regular doctor used more healthcare services than a matched group of people who was self-reportedly not having a regular doctor. For specialist and hospital utilization, the statistically significant differences were in the likelihood if the service was used but not in the number of specialist visits or hospital nights among users. Copyright © 2016 John Wiley & Sons, Ltd.

摘要

加拿大拥有一个提供医院和医生福利的全民健康保险计划,这提供了一个关于连续性护理是否真的会降低或提高服务利用率的自然实验。我们正在评估的问题是,有固定医生的加拿大人是否比没有固定医生的加拿大人使用更多的医疗资源?我们使用了两种统计方法,包括倾向得分匹配和零膨胀负二项回归,分别分析了2010年和2007/2008年加拿大社区健康调查的数据,以记录在全科医生、专科医生和医院服务的使用方面,自称有和没有固定医生的人之间的差异。结果表明,对于所使用的所有两种统计方法和两个数据集,一致的情况是,自称有固定医生的人比一组自称没有固定医生的匹配人群使用了更多的医疗服务。对于专科医生和医院的使用情况,统计上的显著差异在于使用该服务的可能性,而不在于使用者中专科医生就诊次数或住院天数的多少。版权所有© 2016约翰·威利父子有限公司。

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