Dalhousie University, Halifax, Nova Scotia, Canada.
University of Toronto, Toronto, Ontario, Canada.
Healthc Manage Forum. 2023 Sep;36(5):272-279. doi: 10.1177/08404704231183599. Epub 2023 Jun 20.
Canadian provinces and territories have undertaken varied reforms to how primary care is funded, organized, and delivered, but equity impacts of reforms are unclear. We explore disparities in access to primary care by income, educational attainment, dwelling ownership, immigration, racialization, place of residence (metropolitan/non-metropolitan), and sex/gender, and how these have changed over time, using data from the Canadian Community Health Survey (2007/08 and 2015/16 or 2017/18). We observe disparities by income, educational attainment, dwelling ownership, recent immigration, immigration (regular place of care), racialization (regular place of care), and sex/gender. Disparities are persistent over time or increasing in the case of income and racialization (regular medical provider and consulted with a medical professional). Primary care policy decisions that do not explicitly consider existing inequities may continue to entrench them. Careful study of equity impacts of ongoing policy reforms is needed.
加拿大各省和地区在基本医疗保健的筹资、组织和提供方式上进行了各种改革,但改革对公平性的影响尚不清楚。我们使用加拿大社区健康调查(2007/08 年和 2015/16 年或 2017/18 年)的数据,探讨了按收入、教育程度、住房拥有情况、移民情况、种族化、居住地(都会/非都会)和性别/性别划分的基本医疗保健获取方面的差异,以及这些差异随时间的变化情况。我们观察了收入、教育程度、住房拥有情况、最近移民、移民(常规医疗服务提供地)、种族化(常规医疗服务提供者)和性别/性别方面的差异。在收入和种族化(常规医疗服务提供者和咨询过医疗专业人员)方面,差异随着时间的推移而持续存在或有所增加。基本医疗保健政策决策如果不明确考虑现有的不平等现象,可能会继续加剧这些不平等现象。需要对正在进行的政策改革对公平性的影响进行仔细研究。