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Table 2 Results on relationships between socioeconomic status and utilization of primary-care and specialist physicians

From: Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

author countries age group time physician utilisation SES measure need-adjusted result
Abasolo, Saez, López-Casasnovas [15] Spain ≥ 15 years 4 weeks primary care frequency household income o
specialist o
Agerholm et al. [16] Sweden 25 to 64 years 12 months primary care frequency adjusted household income o4
specialist +
65 to 84 years primary care o4
specialist +
Allin [17] Canada ≥ 15 years 12 months primary care probability adjusted household income +
frequency o
specialist probability +
frequency +
Asada, Kephart [18] Canada ≥ 20 years 12 months primary care probability education +
adjusted household income +
conditional frequency education
adjusted household income
specialist probability education +
adjusted household income +
conditional frequency education +
adjusted household income o
Bago d’Uva, Jones, van Doorslaer [19] Austria, Belgium, Denmark, Finland, Greece, Ireland, Italy, Netherlands, Portugal, Spain ≥ 16 years 12 months primary care frequency adjusted household income 5
specialist +
Baron-Epel, Garty, Green [20] Israel ≥ 21 years 4 weeks primary care probability education
household income
specialist education +
household income o
Beckman, Anell [21] Sweden 25 to 44 years 2 years primary care probability household income +
45 to 64 years o4
65 to 84 years +
Bergmann, Kalcklösch, Tiemann [22] Germany ≥ 18 years 12 months primary care frequency index
Bourke [23] Ireland ≥ 16 years 12 months primary care probability adjusted household income o
frequency
conditional frequency
specialist probability +
frequency o
conditional frequency
Bremer, Wübker [24] Germany ≥ 50 years 12 months primary care probability education o
adjusted household income o
conditional frequency education o
adjusted household income o
specialist probability education o
adjusted household income +
conditional frequency education o
adjusted household income +
Bremer, et al. [25] Pooled Data from 16 European Countries ≥ 50 years 12 months primary care frequency education
Crespo-Cebada, Urbanos-Garrido [26] Spain ≥ 50 years 12 months primary care probability education o
adjusted household income o
conditional frequency education o
adjusted household income o
Devaux, de Looper [27] Austria, Belgium, Canada, Czech Republic, Denmark, Estonia, Finland, France, Hungary, Ireland, New Zealand, Poland, Slovak Republic, Slovenia, Spain, Switzerland, UK ≥ 15 years 12 months1 primary care probability adjusted household income o5
frequency o5
specialist probability + 5
frequency + 5
Fjaer, et al. [28] Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Hungary, Ireland, Israel, Lithuania, Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland, UK 25 to 75 years 12 months primary care probability education o5
specialist + 5
Garrido-Cumbrera, et al. [29] Spain ≥ 16 years 4 weeks primary care probability occupation
specialist +
Glazier et al. [30] Canada 20 to 79 years 2 years primary care probability education o
adjusted household income o
conditional frequency education
adjusted household income
specialist probability education +
adjusted household income o
conditional frequency education +
adjusted household income o
Gonzalez-Alvarez, Barranquero [31] Spain ≥ 16 years 12 months primary care probability education
adjusted household income o
frequency education
adjusted household income o
conditional frequency education
adjusted household income o
specialist probability education +
adjusted household income +
frequency education +
adjusted household income +
conditional frequency education o
adjusted household income o
Grasdal, Monstad [32] Norway 16 to 69 years 12 months primary care probability adjusted household income o
conditional frequency o
specialist probability + 6
conditional frequency o
Gruber, Kiesel [33] Germany 50 to 90 years 12 months specialist probability education o4
adjusted household income o4
frequency education o
adjusted household income o
Habicht, Kunst [34] Estonia 25 to 74 years 6 months primary care probability education o
adjusted household income +
specialist education +
adjusted household income +
Hansen, et al. [35] Norway 30 to 87 years 12 months primary care probability education o
household income o
occupation o
conditional frequency education o4
household income
occupation o
Hoebel, et al. [12] Germany 18 to 69 years 12 months primary care probability index o
conditional frequency
specialist probability +
conditional frequency o
Hoeck, et al. [36] Belgium ≥ 65 years 2 months primary care probability education o
adjusted household income o
specialist education o
adjusted household income o
Hoeck, et al. [37] Belgium ≥ 16 years 2 months primary care probability education o
adjusted household income o
conditional frequency education o
adjusted household income o
specialist probability education +
adjusted household income o
conditional frequency education o
adjusted household income o
≥ 65 years primary care probability education o
adjusted household income o
conditional frequency education o
adjusted household income o
specialist probability education +
adjusted household income o
conditional frequency education o
adjusted household income o
Korda, et al. [38] Australia 53 to 58 years 12 months primary care probability occupation o
conditional frequency o
specialist probability +
conditional frequency o
La Parra-Casado, et al. [39] Spain ≥ 16 years 4 weeks primary care probability occupation o
Lichte [40] Germany ≥ 18 years 3 months primary care conditional frequency education o
household income o
Lostao, et al. [41] UK ≥ 16 years 2 weeks2 primary care probability occupation o
specialist o
Spain primary care
specialist +
Lu, et al. [42] Hong Kong ≥ 16 years 1 months primary care probability income +
frequency +
specialist probability o
frequency o
Masseria, Giannoni [43] Italy >  16 years 4 weeks primary care probability education
adjusted household income +
specialist education +
adjusted household income o
McDonald, Conde [44] Canada 55 to 79 years 12 months primary care probability education +
adjusted household income +
conditional frequency education o
adjusted household income o
specialist probability education +
adjusted household income +
conditional frequency education +
adjusted household income o
Mosquera, et al. [45] Sweden 16 to 25 years 3 months primary care probability household income
Nolan [46] Ireland ≥ 16 years 12 months primary care frequency education o
adjusted household income o
Palència, et al. [47] Spain ≥ 16 years 4 weeks primary care probability occupation
specialist +
Põlluste, Kalda, Lember [48] Estonia 65 to 74 years 12 months primary care probability education o
adjusted household income o
specialist education o
adjusted household income o
Rattay et al. [49] Germany 18 to 79 years 12 months primary care probability index
Regidor, et al. [50] Spain 16 to 74 years 2 weeks primary care probability education
adjusted household income
occupation
specialist education +
adjusted household income +
occupation +
Reibling, Wendt [51] Austria, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, Sweden, Switzerland ≥ 50 years 12 months specialist probability education + 5
Rogowski et al. [52] USA ≥ 65 years 12 months primary care frequency education o
adjusted household income o
specialist education +
adjusted household income o
Ryvicker, Gallo, Fahs [53] USA 60 to 99 years 12 months primary care probability education +
San Sebastian, Mosquera, Gustafsson [54] Sweden 18 to 84 years 3 months primary care probability income +
specialist o
Schnitzer, et al. [55] Germany 18 to 79 years 12 months specialist frequency education +
Schulz [56] Pooled Data from 13 European Countries ≥ 40 years 12 months primary care frequency education
specialist +
Stirbu, et al. [11] Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, Netherlands, Norway ≥ 15 years 12 months3 primary care probability education o5
specialist +
Suominen-Taipale, et al. [57] Finland 65 to 74 years 12 months primary care probability education o
specialist +
Norway primary care +
specialist +
Tavares, Zantomio [58] Italy ≥ 50 years 12 months primary care frequency education
specialist +
Spain primary care
specialist +
Portugal primary care +
specialist +
Terraneo [10] Pooled Data from 12 European Countries ≥ 50 years 12 months primary care probability education o
specialist +
Thode et al. [59] Germany 18 to 79 years 12 months primary care frequency index
Tille, et al. [60] Germany ≥ 18 years 12 months primary care frequency education
specialist o
van Doorslaer, Koolman, Jones [61] Austria, Belgium, Denmark, Germany, Greece, Ireland, Italy, Luxemburg, Netherlands, Portugal, Spain, UK ≥ 16 years 12 months primary care probability adjusted household income o5
frequency 5
conditional frequency 5
specialist probability + 5
frequency + 5
conditional frequency o5
van Doorslaer, Masseria, Koolman [62] Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Netherlands, Norway, Portugal, Spain, Switzerland, UK ≥ 16 years 12 months primary care probability adjusted household income o5
conditional frequency 5
specialist probability +
conditional frequency + 5
van Ourti [63] Belgium >  15 years 12 months primary care frequency adjusted household income
specialist o
Vasquez, Paraje, Estay [64] Chile ≥ 18 years 3 months primary care probability adjusted household income +
frequency +
specialist probability +
frequency +
Vedsted et al. [65] Denmark 20 to 34 years 12 months primary care conditional frequency education o
35 to 49 years o
50 to 64 years o4
Vedsted, Olesen [66] Denmark 20 to 64 years 12 months primary care conditional frequency education o4
Vikum, et al. [67] Norway ≥ 20 years 12 months primary care probability education o4
20 to 67 years income o4
≥ 20 years specialist education +
20 to 67 years income +
Vikum, Krokstad, Westin [68] Norway ≥ 20 years 12 months primary care probability education
adjusted household income o
specialist education +
adjusted household income +
  1. 1, deviating for probability in Denmark: 3 months; and for frequency in some EHIS countries: 4 weeks
  2. 2, deviating for outpatient consultations in UK: 3 months
  3. 3, deviating for consultations in Netherlands and Belgium: 2 months
  4. 4, significant results only in gender-specific subgroup-analyses
  5. 5, results differ for several countries, only the most frequent results are reported
  6. 6, only for private specialists; results for hospital outpatient visits are non-significant
  7. +, higher utilization in the most advantaged; o, no significant differences; -, higher utilization in the most deprived
  8. ↑, adjustment for at least gender, age and any general health variable (e.g., self-rated health or chronic conditions); ↓, relevant adjustments for need have not been conducted
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