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APHA Scientific Session and Event Listing

Michael E. Martinez, MPH, MHSA, Debra L. Blackwell, PhD, and Jane F. Gentleman, PhD. National Center for Health Statistics, 3311 Toledo Rd. Room 2332, Hyattsville, MD 20782, 301-458-4758, bmd7@cdc.gov

Canada and the United States employ strikingly different approaches to financing medical care for their residents. Canada has a single payer plan in which virtually all residents have government-sponsored health insurance coverage for doctor visits and hospitalizations. In contrast, in the U.S., most funding for health care services comes from insurance providers.

Data from the Joint Canada/United States Survey of Health (JCUSH) were used to examine differences between the two countries. Results will be presented from two Poisson regressions that predicted rates of hospitalization and rates of medical doctor contact given various demographic, socio-economic, and health status factors, and focusing on health insurance coverage status as a predictor. These findings will then be compared with earlier findings from two logistic regressions that used the same data and dichotomously predicted whether a person had been hospitalized overnight in the previous 12 months and whether a person had contacted a medical doctor in the previous 12 months.

Odds ratios from logistic models showed that health insurance coverage status was not associated with hospitalization in the U.S., whereas Poisson models showed that hospitalization rates for the uninsured were significantly different from hospitalization rates for the insured. In Canada, logistic models showed that race was not associated with hospitalization, whereas Poisson models showed that hospitalization rates for non-whites and whites were significantly different. Other comparisons of findings from the logistic and Poisson models predicting hospitalizations and medical doctor contacts in the two countries will be presented.

Learning Objectives: At the conclusion of the session, participants in this session will

• Have learned about access to health care in the United States and Canada;
• Understand the differences between Poisson regression and logistic regression.

Presenting author's disclosure statement:

Any relevant financial relationships? No