The relationship between occupation, work patterns and utilization of general practitioners in four Canadian provinces

Canada's health care system is generally seen to be equitable to the degree that access to care is not dependent upon ability to pay. Despite the lack of direct cost to the consumer, there may still be non-financial barriers to access. This study assessed the degree to which occupation and work patterns may act as non-financial barriers to accessing general practitioner (GP) services.; Data from the 1996/97 cross-sectional wave of the National Population Health Survey were linked to administrative data from provincial Medicare databases in Nova Scotia, Manitoba, Saskatchewan and British Columbia. Negative binomial regression was used to evaluate the impact of occupation and work patterns on volume of GP services consumed in a one-year period, adjusted for other determinants of health care utilization.; The relationship between occupation, work patterns and utilization of GP services was strongly determined by regional context. In weighted analyses, which favored the province of British Columbia, no evidence of an adjusted relationship between occupation, work patterns and GP utilization was found. In unweighted analyses however, individuals who worked long hours (greater than 45 hours per week) had significantly fewer GP visits during the study year compared to part-time workers. While occupation alone did not have a significant relationship with GP utilization after adjustment for other determinants of utilization, when combined with the number of working hours, white-collar workers with long hours visited a GP significantly less often than workers with regular hours. Health status variables were consistently among the strongest predictors of GP utilization. Household income was not associated with adjusted GP utilization.; This study provides the first known empirical evidence that long working hours is associated with reduced utilization of GP services. This finding should be further investigated in a larger study that can support stratification by province in order to better assess regional effects.