Description | Specific Indicators | Corresponding Mandatory Objectives | Corresponding National Indicators | Data Sources | Alternative Data Sources | ICD Codes | Analysis Check List | Method of Calculation | Basic Categories | Indicator Comments | Cross-References to Other Sections | References Description Specific Indicators
Contacts with medical doctors Contacts with family doctors or general practitioners Contacts with specialists Corresponding Mandatory Objective Corresponding National Indicator Data Sources (see Resources: Data Sources) Numerator & Denominator: Canadian Community Health Survey (CCHS) Original source: Statistics Canada Distributed by: 1. Knowledge Management and Reporting Branch, Ontario MOHLTC 2. Statistics Canada Suggested citation (see Data Citation Notes): 1. Canadian Community Health Survey [year], Statistics Canada, Share File, Knowledge Management and Reporting Branch, Ontario MOHLTC 2. Canadian Community Health Survey [year], Statistics Canada, Public Use Microdata File, Statistics Canada Numerator & Denominator: 1996/97 Ontario Health Survey (OHS) Original source: Statistics Canada Distributed by: 1. Knowledge Management and Reporting Branch, Ontario MOHLTC 2. Statistics Canada Suggested citation (see Data Citation Notes): 1. Ontario Health Survey 1996/97, Statistics Canada, Share File, Knowledge Management and Reporting Branch Branch, Ontario MOHLTC 2. Ontario Health Survey 1996/97, Statistics Canada, Public Use Microdata File, Statistics Canada Numerator & Denominator: 1990 Ontario Health Survey (OHS) Original source: Ontario Ministry of Health (renamed Ministry of Health and Long-Term Care) Distributed by: Knowledge Management and Reporting Branch, Ontario MOHLTC Suggested citation (see Data Citation Notes): Ontario Health Survey 1990, Ontario MOHLTC Survey Questions 2003 Canadian Community Health Survey (Cycle 2.1): Questions HCU_Q02a, HCU_Q02c: “(Not counting when you were an overnight patient) In the past 12 months, how many times have you seen, or talked on the telephone, about your physical, emotional or mental health with: a)… a family doctor or general practitioner OR c)… any other medical doctor (such as a surgeon, allergist, orthopedist, gynaecologist or psychiatrist)?” 2000/01 Canadian Community Health Survey (Cycle 1.1): Question HCQ02 (Variables HCUA_02A, HCUA_02C): “(Not counting when you were an overnight patient) In the past 12 months, how many times have you seen, or talked on the telephone, about your physical, emotional or mental health with: a)… a family doctor or general practitioner OR c)… any other medical doctor (such as a surgeon, allergist, orthopedist, gynaecologist or psychiatrist)?” 1996/97 Ontario Health Survey: Question UTIL_Q2 (Variables HCC6_2A, HCC6_2C): “(Not counting when you were an overnight patient) In the past 12 months, how many times have you seen, or talked on the telephone with (a/an/any) [fill category] about your physical, emotional or mental health? a)… a family doctor or general practitioner OR c)… other medical doctor (such as a surgeon, allergist, orthopedist, gynaecologist or psychiatrist)?” 1990 Ontario Health Survey: Variable Q1A: “Did you see or talk to a general practitioner about your health in the past twelve months?” 1) Yes, 2) No Q1A_1: “How many times?” Q1B: “Did you see or talk to a specialist about your health in the past twelve months?” 1) Yes, 2) No Q1B_1: “How many times?” Analysis Check List
The number of “don’t know” (coded as 997), “refusal” (coded as 998) and “not stated” (coded as 999) respondents are likely small and can be excluded. Users should check numbers before excluding these non-respondents. When determining contacts with medical doctors, which combines family doctor/general practitioner with specialist, use the following format to determine non-respondents: (HCUA_02a = 997, 998 or 999) and (HCUA_02c = 997, 998 or 999). A person must have non-response answers to both questions to be excluded. This is appropriate when considering whether or not a person saw a doctor. More complex rules are necessary for determining the number of visits in cases where a respondent answered one of the questions but not the other. Because the non-response is generally very low, the final percentage will likely not change regardless of the approach. Before releasing and/or publishing these data, users should ensure that the number of sampled respondents who contributed to the estimate is at least 30 (or 10 if bootstrapping is done), regardless of the estimate’s coefficient of variation. For estimates with the minimal sample size, determine the coefficient of variation of the rounded weighted estimate and follow the guidelines below: Acceptable (0.0 - 16.5) Estimates can be considered for general unrestricted release. Requires no special notation. Marginal (16.6 - 33.3) Estimates can be considered for general unrestricted release but should be accompanied by a warning cautioning of high sampling variability. Unacceptable (greater than 33.3) Statistics Canada recommends not releasing estimates of unacceptable quality. However, if the user chooses to do so then estimates should be flagged and the following warning should accompany the estimates: “The user is advised that . . .(specify the data) . . . do not meet Statistics Canada’s quality standards for this statistical program. Conclusions based on these data will be unreliable and most likely invalid”. These data and any consequent findings should not be published. If the user chooses to publish these data or findings, then this disclaimer must be published with the data. The release guidelines for the 1990 OHS are slightly different: No qualification (C.V. less than 16.6), Qualified estimate (C.V. of 16.6 – 25.0), Suppress estimate (C.V. greater than 25.0). Method of Calculation Contact with medical doctors: Weighted number of respondents aged 12+ reporting one or more contacts with a family doctor or general practitioner, or with any other medical doctor | * 100 | Total weighted population aged 12+ | CCHS 2000/01 Variables: HCUA_02A + HCUA_02C Contact with family doctors or general practitioners: Weighted number of respondents aged 12+ reporting one or more contacts with a family doctor or general practitioner | * 100 | Total weighted population aged 12+ | CCHS 2000/01 Variable: HCUA_02A Contact with specialists: Weighted number of respondents aged 12+ reporting one or more Contacts with a specialist | * 100 | Total weighted population aged 12+ | CCHS 2000/01 Variable: HCUA_02C Basic Categories
Age groups: 12-19, 20-44, 45-64, 65+. Sex: male, female. Geographic areas for: CCHS – all 37 Public Health Units and16 District Health Councils in Ontario; 1996/97 OHS – 23 health areas; 1990 OHS – all 42 Public Health Units and 32 District Health Councils that existed at the time. Number of contacts: 0, 1, 2, 3+. Indicator Comments
Contact with physicians can provide a measure of the accessibility, availability and need for services. Utilization increases with age and is higher for women than men because of childbearing and reproductive health. Utilization has an inverse relationship with income: those with lower incomes tend to have more visits to medical doctors.1 Contact with a medical doctor includes telephone consultation, contact at workplace, school, etc. A follow-up question (HC_Q03) in the CCHS asks about the place of the most recent contact. Respondents who have been an overnight patient in a hospital, nursing home or convalescent home in the past 12 months would likely have contact with a physician during their stay, but this question specifically asks respondents to exclude those contacts. Contact with a specialist includes any medical doctor (other than a family doctor or general practitioner, or eye specialist) such as a surgeon, allergist, orthopaedist, gynaecologist or psychiatrist. Contact with an eye specialist is a separate measure and may involve contact with a physician (ophthalmologist) or non-physician (optometrist). For children <18, contacts with a paediatrician are captured under contact with family doctor or general practitioner. Questions in the 2000/01 CCHS and 1996/97 OHS were identical; however, data may not be comparable to similar questions in the 1990 OHS. Based on the 2000/01 CCHS Share File (excluding non-respondents): 81% of Ontarians aged 12 years and older saw or talked to a general practitioner about their health in the past twelve months; 29% of Ontarians aged 12 years and older saw or talked to a specialist about their health in the past twelve months; 83.5% of Ontarians aged 12 years and older saw or talked to a medical doctor (general practitioner or specialist) about their health in the past twelve months. Cross-References to Other Sections References
Public Health Research, Education and Development Program (PHRED). Report on the Health Status of the Residents of Ontario. February 2000. (available at http://www.opha.on.ca, the website for the Ontario Public Health Association, under General Resources - http://www.opha.on.ca/resources/e-h.html#general). Finkelstein MM. Do factors other than need determine utilization of physicians' services in Ontario? CMAJ. 2001 Sep 4;165(5):565-70. McIsaac W, Goel V, Naylor D. Socio-economic status and visits to physicians by adults in Ontario, Canada. J Health Serv Res Policy. 1997 Apr;2(2):94-102. Dunlop S, Coyte PC, McIsaac W. Socio-economic status and the utilisation of physicians' services: Results from the Canadian National Population Health Survey. Soc Sci Med. 2000 Jul;51(1):123-33. Date of Last Revision: March 19, 2004
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