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Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey.
Am J Public Health. 2006 Jul;96(7):1300-7
Publication Type
Karen E Lasser
David U Himmelstein
Steffie Woolhandler
Author Affiliation
Department of Medicine, The Cambridge Health Alliance and Harvard Medical School, Cambridge, Mass, USA.
Am J Public Health. 2006 Jul;96(7):1300-7
Publication Type
Canada - epidemiology
Delivery of Health Care - economics - standards - utilization
Emigration and Immigration
Ethnic Groups
Health Services Accessibility - economics - statistics & numerical data
Health services needs and demand - economics - statistics & numerical data
Health Status Indicators
Life expectancy
Logistic Models
Middle Aged
Multivariate Analysis
National Health Programs - economics - standards - utilization
Patient Satisfaction - ethnology
Quality of Health Care
Socioeconomic Factors
United States - epidemiology
Universal Coverage
We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status.
We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures.
In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States.
United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.
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PubMed ID
16735628 View in PubMed
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