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Table 3 Two-part models of general practitioner, specialist, and hospital services

From: Equity in health services use and intensity of use in Canada

  General practitioners Specialists Hospitals
  Logistic Zero-truncated negative binomial Logistic Zero-truncated negative binomial Logistic Zero-truncated negative binomial
Variable OR IRR OR IRR OR IRR
Age *** *** *** *** *** ***
   20–24 1.00 1.00 1.00 1.00 1.00 1.00
   25–29 1.18 1.01 0.97 1.31 ** 1.06 0.92
   30–34 0.89 0.89 ** 1.04 1.14 0.89 1.04
   35–39 0.73 ** 0.83 *** 0.83 * 1.06 0.72 ** 1.17
   40–44 0.72 *** 0.76 *** 0.73 *** 1.01 0.62 *** 0.96
   45–49 0.68 *** 0.75 *** 0.76 ** 0.86 0.58 *** 1.26
   50–54 0.80 * 0.76 *** 0.82 * 0.86 0.59 *** 1.62 **
   55–59 0.81 * 0.72 *** 0.77 ** 0.78 ** 0.68 ** 1.67 **
   60–64 0.79 * 0.68 *** 0.72 *** 0.85 * 0.71 ** 1.45 *
   65–69 0.73 * 0.56 *** 0.45 *** 0.60 *** 1.02 2.02 **
   70–74 0.88 0.53 *** 0.43 *** 0.51 *** 0.92 2.33 ***
   75–79 0.81 0.58 *** 0.43 *** 0.52 *** 1.07 2.29 ***
   80+ 0.96 0.61 *** 0.27 *** 0.46 *** 1.18 2.73 ***
Sex 0.35 *** 0.74 *** 0.44 *** 1.00 0.67 ** 1.20
Sex × age^^ *** *** *** * ***  
Minority 1.26 *** 1.14 *** 0.95 0.73 *** 0.76 *** 0.90
Education * *** ***    
   Post-secondary graduate 1.00 1.00 1.00 1.00 1.00 1.00
   Secondary graduate 0.99 1.04 ** 0.91 *** 0.98 1.01 0.98
   Less than secondary education 0.90 ** 1.08 *** 0.74 *** 0.91 * 1.05 0.96
   Currently in school 1.10 0.92 1.03 1.09 0.74 1.58
   Missing 1.01 1.07 0.86 0.95 1.01 1.18
Home ownership   ***   *** ** *
   Own the dwelling 1.00 1.00 1.00 1.00 1.00 1.00
   Do not own the dwelling 0.96 1.08 *** 0.99 1.15 *** 1.14 ** 1.13 **
   Missing 0.70 1.02 0.82 0.82 1.37 1.00
Household income *** ** ***    *
   Highest 1.00 1.00 1.00 1.00 1.00 1.00
   Upper middle 0.93 * 1.06 ** 0.87 *** 0.98 0.97 1.07
   Middle 0.83 *** 1.06 ** 0.79 *** 0.92 0.94 1.17 *
   Lower middle 0.79 *** 1.11 *** 0.76 *** 0.90 0.93 1.25 **
   Lowest 0.70 *** 1.12 ** 0.67 *** 0.97 1.06 1.29 *
   Missing 0.87 ** 1.05 0.83 ** 0.96 0.95 1.21 *
Self-help group participation^ 1.30 ** 1.18 *** 1.36 *** 1.28 *** 1.34 *** 1.41 ***
Sense of belonging to community **      
   Yes 1.00 1.00 1.00 1.00 1.00 1.00
   No 0.88 *** 0.97 * 0.96 1.01 0.94 1.04
   Missing 0.64 ** 0.91 0.91 0.80 1.00 0.86
Health Utilities Index 0.95 0.93 *** 0.91 ** 0.91 * 1.04 0.99
Self-perceived health *** *** *** *** *** ***
   Excellent 1.00 1.00 1.00 1.00 1.00 1.00
   Very good 1.21 *** 1.21 *** 1.17 *** 1.19 *** 1.00 1.10
   Good 1.25 *** 1.53 *** 1.38 *** 1.44 *** 1.39 *** 1.36 ***
   Fair or poor 1.51 *** 2.00 *** 1.81 *** 1.87 *** 1.99 *** 1.80 ***
   Missing 0.82 1.54 * 0.62 0.99 4.11 * 1.36
Stress *** ***     ***
   Not at all or not very stressed 1.00 1.00 1.00 1.00 1.00 1.00
   A bit stressed 1.07 * 1.03 1.02 1.00 0.90 ** 0.92
   Quite a bit or extremely stressed 1.16 *** 1.10 *** 1.05 1.06 0.94 0.92 ***
   Missing 1.31 0.99 0.93 1.34 0.76 1.45 *
Depression *** *** *** *** *** ***
   0 1.00 1.00 1.00 1.00 1.00 1.00
   1 0.96 1.17 ** 1.10 1.05 1.19 0.93
   2 1.33 *** 1.30 *** 1.31 *** 1.44 *** 1.34 *** 1.32 ***
   3 1.92 *** 1.47 *** 1.56 *** 1.74 *** 1.73 *** 1.34 **
   4 1.91 *** 1.78 *** 1.61 *** 2.03 *** 2.67 *** 1.98 ***
   Missing 0.90 1.19 *** 1.13 1.39 *** 1.43 ** 1.03
ADL ** *** *** *** *** *
   No limitation 1.00 1.00 1.00 1.00 1.00 1.00
   Sometimes 0.98 1.08 *** 1.11 ** 1.13 ** 0.94 0.93
   Often 1.19 ** 1.17 *** 1.35 *** 1.20 *** 1.19 ** 1.07
IADL *** *** *** *** *** ***
   No 1.00 1.00 1.00 1.00 1.00 1.00
   Yes 1.36 *** 1.35 *** 1.41 *** 1.40 *** 1.83 *** 1.50 **
   Missing 1.76 1.09 1.42 1.35 1.52 1.22
Birth^ 1.06 1.53 *** 1.24 *** 2.11 *** 5.26 *** 1.03
Injury^ 2.30 *** 1.29 *** 1.43 *** 1.11 ** 1.75 *** 1.09
Injury × age^^ ** ***     
Number of chronic conditions *** *** *** ** ** *
   0 1.00 1.00 1.00 1.00 ** 1.00 1.00
   1 1.52 *** 1.32 *** 1.67 *** 1.17 ** 1.41 *** 1.20 **
   2 2.05 *** 1.57 *** 2.29 *** 1.20 ** 1.48 *** 1.27 **
   3 2.44 *** 1.73 *** 2.67 *** 1.26 *** 1.56 *** 1.33 **
   4+ 2.72 *** 1.83 *** 3.47 *** 1.48 *** 1.50 *** 1.31 **
   Missing 1.04 1.74 *** 2.16 *** 1.20 1.41 * 1.32
Food allergies^ 0.86 * 0.93 ** 0.84 *** 0.95 0.95 1.00
Other allergies^ 0.91 * 0.93 *** 0.86 0.97 0.96 0.92 *
Other allergies × age^^    ***    
Asthma^ 1.10 1.04 * 0.90 ** 0.97 1.13 * 0.97
Arthritis^ 1.19 *** 1.01 1.00 0.93 * 0.98 0.85 ***
High blood pressure^ 1.94 *** 1.20 *** 0.85 *** 0.91 1.12 * 0.57
High blood pressure × age^^       **
Migraine^ 0.87 1.08 ** 0.89 ** 0.94 0.99 0.84 **
Migraine × age^^ ***      
Urinary incontinence^ 1.07 0.93 * 1.13 * 0.92 1.14 1.13 *
Urinary incontinence × age^^       
Diabetes^ 1.35 ** 1.20 1.02 1.08 8.71 *** 1.10
Diabetes × age^^   **    ***  
Chronic bronchitis^ 1.12 0.99 0.84 ** 0.95 1.19 ** 1.04
Heart disease^ 1.37 *** 1.13 *** 1.60 *** 0.93 1.91 *** 0.20 **
Heart disease × age^^       **
Cancer^ 0.26 1.20 *** 3.53 *** 1.64 2.46 0.45
Cancer × age^^ ***    ** *** ***
Stomach or intestinal ulcers^ 1.17 1.10 ** 1.77 * 0.88 * 1.15 0.92
Stomach or intestinal ulcers × age^^    **    
Bowel disorders^ 1.37 * 1.10 1.49 *** 1.05 1.34 *** 3.55 ***
Bowel disorders × age^^       ***
Eye problem^ 0.76 ** 0.90 *** 0.84 *** 1.00 0.96 0.31 **
Eye problem × age^^       **
Thyroid condition^ 1.63 *** 1.06 * 1.07 0.98 0.92 0.87
Epilepsy^ 1.14 0.99 1.15 1.12 1.34 1.16
Epilepsy × age^^       ***
Chronic fatigue syndrome^ 0.93 1.05 0.94 0.98 0.84 * 1.18
Chronic fatigue syndrome × age^^       **
Stroke^ 2.17 0.54 0.80 * 0.99 1.34 ** 1.42 ***
Stroke × age^^ ** **     
Overweight   *** ** *** *  
   Underweight or acceptable weight 1.00 1.00 1.00 1.00 1.00 1.00
   Overweight 1.06 * 1.03 * 0.99 1.00 1.02 1.03
   Missing 0.97 1.33 *** 1.22 ** 1.34 *** 0.78 * 0.90
Smoking ***   ***    
   Never smoked 1.00 1.00 1.00 1.00 1.00 1.00
   Former smoker 1.04 1.02 1.14 *** 1.01 1.09 1.05
   Current smoker 0.77 *** 1.00 0.90 ** 0.98 0.98 1.07
   Missing 1.03 0.88 0.91 0.93 1.24 0.65
Drinking ** ***   *** *** ***
   Not regular drinker 1.00 1.00 1.00 1.00 1.00 1.00
   Regular drinker 1.09 ** 0.89 *** 1.04 0.85 *** 0.74 *** 0.97 ***
   Missing 1.43 * 0.81 * 0.97 1.37 1.33 0.91
Physical activity ** **    ***  
   Active 1.00 1.00 1.00 1.00 1.00 1.00
   Moderate or inactive 1.08 * 1.06 *** 1.04 1.05 1.18 *** 0.99
   Missing 1.51 ** 1.12 1.10 1.33 1.27 1.38
Fruit and vegetable consumption ** *** ***   *  
   5+ servings a day 1.00 1.00 1.00 1.00 1.00 1.00
   Less than 5 servings a day 0.94 * 0.92 *** 0.88 *** 0.97 0.91 ** 0.97
   Missing 0.75 ** 0.88 * 0.78 * 0.96 0.79 0.78
Alternative health care^ 1.43 *** 1.20 *** 1.28 *** 1.11 ** 0.92 1.00
Province of residence ** ** *** ** ** **
   ON 1.00 1.00 1.00 1.00 1.00 1.00
   NF 1.59 *** 1.20 *** 1.04 0.92 1.29 ** 1.22 *
   PEI 1.05 0.93 * 0.88 * 0.97 1.48 *** 1.27 **
   NS 1.00 1.03 0.91 * 0.80 *** 1.02 1.06
   NB 1.23 *** 0.90 *** 1.02 0.71 *** 1.40 *** 1.34 ***
   QC 0.66 *** 0.74 *** 1.50 *** 0.80 *** 1.34 *** 0.96
   MB 0.84 *** 0.99 0.90 * 1.02 1.18 * 1.08
   SK 1.12 * 1.06 * 0.79 *** 0.81 ** 1.38 *** 1.00
   AL 0.92 * 1.08 ** 0.71 *** 0.87 ** 1.17 ** 1.05
   BC 1.03 1.14 *** 0.75 *** 1.03 1.05 1.03
α   0.95   2.99   1.64
n 110923 89151 111087 31819 111104 11291
Pseudo-R square 0.12   0.11   0.15  
Log likelihood -49891.01 -38209980 -60018.27 -11517957 -27813.50 -5128804.50
Wald chi-square~ 4847.42 *** 13954.43 *** 6072.91 *** 2619.61 *** 5297.16 *** 2795.83 ***
  1. ^ The reference group is the absence of the condition or no use.
  2. ^^ Fifteen interaction terms are included. The coefficients are not reported due to the limited space. The reported statistical significance is overall.
  3. * 0.01 p < 0.05, ** 0.001 p < 0.01, *** p < 0.001, Given that we did not fully account for the design effect, we considered variables with a statistical significance at the 1% level as significant.
  4. Statistical significance in the row of a variable name indicates overall significance of all categories combined including missing category.
  5. ~ Wald chi-square test of the joint significance of the repressors.