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Comparative Study
. 2009 Feb;55(2):178-179.e5.

Determining use of preventive health care in Ontario: comparison of rates of 3 maneuvers in administrative and survey data

Li Wang  1 , X Nie Jason, Ross E G Upshur
Affiliations
Comparative Study

Determining use of preventive health care in Ontario: comparison of rates of 3 maneuvers in administrative and survey data

Li Wang et al. Can Fam Physician. 2009 Feb.

Abstract
in English, French

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.

OBJECTIF: Établir les taux de vaccination anti-grippale, de mammographie et de test de Papanicolaou en comparant les données provenant de la banque de données d’Assurance-santé de l’Ontario aux taux obtenus par auto-déclaration à l’Enquête sur la santé des collectivités canadiennes.

TYPE D’ÉTUDE: Étude de cohorte rétrospective à partir des données de l’Enquête sur la santé des collectivités canadiennes 2000–2001 de Statistique Canada et celles de la base de données administratives de l’Assurance-santé de l’Ontario pour la même période.

CONTEXTE: Ontario.

PARTICIPANTS: Les personnes de 12 ans et plus ayant reçu le vaccin anti-grippal, les femmes de 35 ans et plus ayant eu des mammographies au cours des 2 dernières années, et celles de 18 ans et plus ayant subi des tests de Papanicolaou au cours des 3 dernières années et qui avaient participé à l’Enquête sur la santé des collectivités canadiennes de 2001.

PRINCIPAUX PARAMÈTRES ÉTUDIÉS: Taux de vaccination anti-grippale, de mammographie et de test de Papanicolaou dans les 14 Réseaux locaux d’intégration des services de santé de l’Ontario, selon le réseau, et l’âge et la situation socioéconomique des patients.

RÉSULTATS: Les taux variaient selon les réseaux sanitaires. L’analyse a montré que les taux de vaccination anti-grippale augmentaient avec l’âge, atteignant un maximum à 75 ans et plus. Les taux de dépistage par mammographie augmentaient avec l’âge mais déclinaient substantiellement à partir de 75 ans. Les taux de Pap test étaient maximaux entre 20 et 39 ans, et diminuaient par la suite. Les taux de mammographie et de Pap test augmentaient avec la situation socioéconomique, mais non celui de vaccination anti-grippale. Pour les 3 interventions, les taux provenant des données de l’Assurance-santé de l’Ontario étaient plus bas que ceux des auto-déclarations à l’Enquête sur la santé des collectivités canadiennes.

CONCLUSION: Trouver les véritables taux d’utilisation des soins de santé préventifs en Ontario n’est pas tâche facile. Il importe d’évaluer ces taux afin d’établir des normes pour la prestation de ces services. On devra développer des programmes ciblant spécifiquement certaines régions et classes socioéconomiques, et certains groupes à risque élevé si on veut accroître l’utilisation globale des services de santé préventifs en Ontario.

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