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Determining use of preventive health care in Ontario

Comparison of rates of 3 maneuvers in administrative and survey data

Ross E.G. Upshur, MD MA CCFP FRCPC
Director of the Primary Care Research Unit and of the Joint Centre for Bioethics at the University of Toronto

Correspondence: Dr Ross E.G. Upshur, Primary Care Research Unit, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room E3-49, Toronto, ON M4N 3M5; telephone 416 480-4753; fax 416 480-4536; e-mailross.upshur{at}sunnybrook.ca

OBJECTIVE To examine rates of influenza vaccination, mammography, and Papanicolaou smear by comparing data obtained from the Ontario Health Insurance Plan administrative database with rates as self-reported in the Canadian Community Health Survey.

DESIGN Retrospective cohort study using data from Statistics Canada’s 2000–2001 Canadian Community Health Survey and from the Ontario Health Insurance Plan administrative database for the same period.

SETTING Ontario.

PARTICIPANTS Those aged 12 and older who had received influenza vaccination, women aged 35 or older who had had mammograms within the past 2 years, and women aged 18 or older who had had Pap smears within the past 3 years who were surveyed during the Canadian Community Health Survey in 2001.

MAIN OUTCOME MEASURES Rates of influenza vaccination, mammography, and Pap smear in Ontario’s 14 Local Health Integration Networks by network, age group, and socioeconomic status.

RESULTS Rates varied by health network. Analysis by age showed that influenza vaccination rates increased with age and peaked among those 75 and older. Rates of mammography screening increased with age but dropped substantially among those 75 and older. Rates of Pap smear peaked among those 20 to 39 and decreased with increasing age. Rates of mammography and Pap smear increased with rising socioeconomic status, but influenza vaccination rates did not differ substantially by socioeconomic status. Rates for all 3 preventive maneuvers were lower in the Ontario Health Insurance Plan data than in the self-reported Canadian Community Health Survey data.

CONCLUSION There are obstacles to finding out the true rates of preventive health care use in Ontario. We need to ascertain these rates in order to establish a criterion standard for delivery of these services. Development of programs to target specific geographic locations, socioeconomic classes, and high-risk groups are needed to increase the overall use of preventive health services in Ontario.

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