ABSTRACT
The objective of this exploratory study was to compare elderly persons’ likelihood of
visiting a family doctor/general practitioner or a medical specialist and the association of
that likelihood with socioeconomic factors and health-related quality of life (a measure
of perceived need) in Canada and the United States. The data were obtained from
the 2002-2003 Joint Canada/United States Survey of Health. The main dependent measure
was whether respondents saw a medical specialist or a general practitioner during
their last health care visit. U.S. patients in the highest household income group were
more likely to have seen a specialist during their last health care visit, after adjusting
for potential confounding factors. Further, visits to a specialist in Canada were determined
by need rather than by household income. In Canada, likelihood of specialist visits by
elderly persons is systematically related to the burden of illness (need) and not
systematically related to income. In the United States, the opposite is the case. These results
suggest that there may be important lessons from Canada on the organization of
health care services.
