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Socioeconomic status and GP visits: using multilevel techniques and different data sources.
Droomers, M., Westert, G.P. Socioeconomic status and GP visits: using multilevel techniques and different data sources. European Journal of Public Health: 2003, 13(4 sup) 95. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background: International research shows consistently that people with a lower socioeconomic status visit their GP more often, irrespective of their generally poorer health. Most of these results are based on people’s self-report of GP visits in the past. Aim: The aim of this paper is to describe socioeconomic differences in GP visits using both (subjective) self-reported data and (objective) GP’s contact registration information as well as to compare the magnitude of socioeconomic differences based on the two types of data. Methods: Data were obtained from the second Dutch National Survey of General Practice which was carried out in 2000 and 2001 covering 104 GP practices containing 195 GPs. Information on GP visits was self-reported during an interview by 9,333 respondents aged 21 years or older who were selected randomly from the listed patients of participating practices. The GP registration system provided additional information on GP visits by the same 9,333 persons. Highest attained educational level indicated socioeconomic status. Multilevel logistic regression was used to calculate educational differences in GP visits, adjusted for age, sex and the need of care, i.e. perceived health. Results: Self-reported information reveals small socioeconomic differences in GP visits (p=0.035). The lowest educated group visits their GP 1.14 (95% CI: 0.98-1.33) times more often than the highest educated group. Only the second lowest educated group visits their GP significantly more often (OR 1.24, 95% CI: 1.09-1.42) compared with the highest educated group. Results of multilevel analyses using the contact registration data will be presented during the conference and compared with the self-reported socioeconomic differences. Conclusion: Although socioeconomic differences are small, lower socioeconomic groups do visit their GP more often in the Netherlands. At the conference the impact of the data source used and the statistical techniques applied will be addressed and implications of variation in GP visits between socioeconomic groups will be discussed. (aut. ref.)
Background: International research shows consistently that people with a lower socioeconomic status visit their GP more often, irrespective of their generally poorer health. Most of these results are based on people’s self-report of GP visits in the past. Aim: The aim of this paper is to describe socioeconomic differences in GP visits using both (subjective) self-reported data and (objective) GP’s contact registration information as well as to compare the magnitude of socioeconomic differences based on the two types of data. Methods: Data were obtained from the second Dutch National Survey of General Practice which was carried out in 2000 and 2001 covering 104 GP practices containing 195 GPs. Information on GP visits was self-reported during an interview by 9,333 respondents aged 21 years or older who were selected randomly from the listed patients of participating practices. The GP registration system provided additional information on GP visits by the same 9,333 persons. Highest attained educational level indicated socioeconomic status. Multilevel logistic regression was used to calculate educational differences in GP visits, adjusted for age, sex and the need of care, i.e. perceived health. Results: Self-reported information reveals small socioeconomic differences in GP visits (p=0.035). The lowest educated group visits their GP 1.14 (95% CI: 0.98-1.33) times more often than the highest educated group. Only the second lowest educated group visits their GP significantly more often (OR 1.24, 95% CI: 1.09-1.42) compared with the highest educated group. Results of multilevel analyses using the contact registration data will be presented during the conference and compared with the self-reported socioeconomic differences. Conclusion: Although socioeconomic differences are small, lower socioeconomic groups do visit their GP more often in the Netherlands. At the conference the impact of the data source used and the statistical techniques applied will be addressed and implications of variation in GP visits between socioeconomic groups will be discussed. (aut. ref.)
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