Equity in healthcare utilization in Canada's publicly funded health system: 2000-2014

Equity in healthcare utilization is a globally accepted measurement of health system performance. In Canada, equity is included as a policy goal in the Federal health legislation that governs healthcare systems. This study used ten cycles of the Statistics Canada Canadian Community Health Survey (CCHS, n = 664,548) to examine the trends in income-related inequities in healthcare utilization in Canada from 2000 to 2014. The horizontal inequity (HI) index was used to quantify inequity in healthcare utilization for general practitioner (GP) visits, specialist physician (SP) visits and hospital admissions (HA) nationally, in urban and rural areas, and for all provinces. Nationally, GP and SP visits show pro-rich inequity, while HA demonstrates pro-poor inequity. This pattern is consistent in the provincial and urban and rural areas results. Trend analysis suggested that inequity in GP visits became more pro-poor in New Brunswick, but more pro-rich in Prince Edward Island and Quebec. Despite the inclusion of equity as a main policy goal, this study demonstrated that inequity in healthcare utilization remains a persistent issue in the Canadian healthcare system.