Hospital utilization in Ontario and the United States: the impact of socioeconomic status and health status

Can J Public Health. Jul-Aug 1996;87(4):253-6.


We compared hospital use in Ontario and the United States for persons with different socioeconomic and health status.

Methods: Cross-sectional study using the 1990 Ontario Health Survey and the 1990 National Health Interview Survey.

Results: Admission rates averaged 31% higher in Ontario than in the United States, but international differences varied markedly across income and health status. At each level of health status, poor Canadians received one quarter to one third more admissions than their counterparts in the United States. However, higher income Canadians reporting excellent to good health had 50% more admissions than Americans, whereas those reporting fair or poor health had 10% fewer admissions.

Conclusions: The observation that higher income sick persons receive less hospital care in Ontario than in the U.S. provides support at the population level for what has been observed for specific technologies. This represents, in part, a redistribution of inpatient care to those most vulnerable to illness, such as the poor, who receive substantially more hospital care in Ontario.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Canada
  • Cross-Sectional Studies
  • Female
  • Health Policy
  • Health Services Accessibility / economics*
  • Health Status
  • Hospitals / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Socioeconomic Factors
  • United States