Canadian Journal of Public Health

, Volume 95, Issue 4, pp 304–308 | Cite as

Beyond Access: Who Reports That Health Care Is Not Being Received When Needed in a Publicly-funded Health Care System?

  • Naomi M. Kasman
  • Elizabeth M. BadleyEmail author


Objectives: To examine the relationship between reporting that health care was not received when needed in Canada’s publicly-funded health care system and contact with the health care system, and to explore whether there is a differential impact of specific chronic conditions.

Methods: Analyses were carried out on the 2000/2001 Canadian Community Health Survey. The proportion of survey respondents who reported that they had not received health care when it was needed was determined overall, and for individuals with selected socio-demographic, health status, and health care utilization characteristics, as well as stratified by various chronic conditions. Multivariate logistic regression was then employed to examine possible predictors of having reported that health care was not received when it was needed during the previous year.

Results: Approximately 13% of Canadians reported that health care was not received when they felt it was needed during the previous year. These individuals reported higher rates of health care utilization, worse health status, were more likely to have chronic health conditions (particularly conditions such as fibromyalgia, Crohn’s disease, and chronic bronchitis for which there is no effective treatment), and were more likely to be female, younger, white, have higher education and lower income.

Conclusion: Reporting that health care was not received when it was needed may not be related to accessibility but rather to a perceived failure of the system to meet the individual’s needs.


Objectifs: Examiner la relation entre, d’une part, les déclarations selon lesquelles des soins de santé n’ont pas été reçus au moment nécessaire, dans le cadre du système de soins de santé canadien financé par l’État, et d’autre part, les contacts avec le système de soins de santé, puis déterminer si certains états chroniques ont des répercussions différentes.

Méthode: Nous avons analysé les résultats de l’Enquête sur la santé dans les collectivités canadiennes (2000–2001). La proportion des répondants ayant déclaré ne pas avoir reçu des soins de santé au moment voulu a été déterminée globalement et individuellement - pour les personnes présentant certaines caractéristiques socio-démographiques, d’état de santé et d’utilisation des soins de santé - puis stratifiée selon divers états chroniques. Par régression logistique à plusieurs variables, nous avons ensuite analysé les prédicteurs éventuels du fait de n’avoir par reçu des soins de santé au moment nécessaire au cours de l’année précédente.

Résultats: Environ 13 % des Canadiens ont déclaré n’avoir pas reçu des soins de santé au moment où ils le jugeaient nécessaire au cours de l’année précédente. Ces personnes ont déclaré des taux supérieurs d’utilisation des soins de santé, un moins bon état de santé, elles étaient plus susceptibles d’avoir des troubles médicaux chroniques (surtout des troubles comme la fibromyalgie, la maladie de Crohn et la bronchite chronique, pour lesquels il n’existe pas de traitement efficace) et d’être des femmes, jeunes, de race blanche, relativement plus scolarisées et à faible revenu.

Conclusion: Les déclarations selon lesquelles des soins de santé n’ont pas été reçus au moment nécessaire pourraient ne pas être liées à l’accessibilité des soins de santé, mais plutôt au défaut perçu du système de répondre aux besoins de l’individu.


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Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  1. 1.Arthritis Community Research and Evaluation Unit, Department of Outcomes and Population HealthToronto Western Hospital Research Institute and the University Health NetworkTorontoCanada
  2. 2.Department of Public Health SciencesUniversity of TorontoCanada

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