People of high socioeconomic status are more likely to be able to access primary care than those of low socioeconomic status, even within a universal health care system in which physicians are reimbursed equally for each patient, found an article published in CMAJ (Canadian Medical Association Journal).
"A person calling a physician's office and asking to be seen as a new primary care patient was more than 50% more likely to be given an appointment if he or she presented as being of high socioeconomic status," says senior author Dr. Stephen Hwang from the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Department of Medicine, University of Toronto. "Because we see this finding in a single-payer universal health insurance system, it provides evidence of discrimination by physicians' offices on the basis of socioeconomic status."
Researchers undertook a randomized controlled audit study to determine whether socioeconomic status as well as health status affected a potential patient's ability to secure an appointment with a primary care physician. They telephoned 568 family physician and general practitioner offices in Toronto, Ontario, Canada, posing as a bank employee (someone of high socioeconomic status) and a welfare recipient (low socioeconomic status) with chronic health conditions (diabetes and back pain) or no major conditions. Final data were available from 375 offices; most responses were from administrative staff.