abstract: 'Reasonable access to health services without financial or other barriers

  is a primary objective of the Canadian health system. Notwithstanding

  such concern about accessibility of services, long waiting times for

  health services have been a prominent health policy issue in recent

  years. Using pooled data from four nationally representative Canadian

  Community Health Surveys (CCHSs, 2000/01, 2003, 2005 and 2010; n =

  266,962) we examine socioeconomic inequality in lengthy wait time (LWT)

  to health care among adults (aged 18-65) in Canada. The relative and

  absolute concentration indices (RC and AC, respectively) are used to

  quantify income-related inequality in LWT in Canada and for its

  provinces. Additionally, we decompose the RC and AC indices to identify

  factors affecting income-related inequality in LWT. Our descriptive

  results show that, on average, 5\% of Canadian adults experienced LWT to

  access health services in the past 12 months. While 3\% of the residents

  of British Columbia and Saskatchewan reported LWT to access health care

  services, this figure was 7\% in Quebec. Our findings also demonstrated

  that LWT was mainly concentrated among the poor in Canada {[}RC =

  -0.039; 95\% confidence interval (CI) -0.049 to -0.028 and AC = -0.067;

  CI -0.086 to -0.049]. The RC and AC suggested statistically significant

  pro-rich inequality of LWT in Nova Scotia, New Brunswick, Quebec,

  Manitoba, Saskatchewan and British Columbia. Decomposition analyses

  indicate that, besides income itself, health status (measured by a set

  of 15 chronic condition indicators), immigration status and geographical

  factors were the most important factors contributing to the

  concentration of LWT among the poor in Canada. These results provide

  some evidence that low-income individuals tend to have lengthier wait

  times for publicly-funded health care in Canada in comparison to their

  high-income counterparts. The observed negative gradient between income

  and long waiting time may be interpreted as evidence of socioeconomic

  inequity within Canadian health care system. Thus, further work is

  required to understand the mechanisms explaining the concentration of

  long wait time among the poor in Canada.'
affiliation: 'Hajizadeh, M (Corresponding Author), Dalhousie Univ, Sch Hlth Adm, Fac
  Hlth Profess, Sir Charles Tupper Med Bldg,5850 Coll St, Halifax, NS, Canada.

  Hajizadeh, Mohammad, Dalhousie Univ, Sch Hlth Adm, Fac Hlth Profess, Sir Charles
  Tupper Med Bldg,5850 Coll St, Halifax, NS, Canada.'
author: Hajizadeh, Mohammad
author-email: m.hajizadeh@dal.ca
author_list:
- family: Hajizadeh
  given: Mohammad
da: '2023-09-28'
doi: 10.1007/s10198-017-0889-3
eissn: 1618-7601
files: []
issn: 1618-7598
journal: EUROPEAN JOURNAL OF HEALTH ECONOMICS
keywords: 'Socioeconomic status; Wait time; Absolute and relative inequalities;

  Decomposition; Canada'
keywords-plus: INEQUALITIES; CARE; EQUITY; SURGERY
language: English
month: APR
number: '3'
number-of-cited-references: '55'
orcid-numbers: Hajizadeh, Mohammad/0000-0002-4591-8531
pages: 369-383
papis_id: ad23f9f8cf1b15735db7d04b76f85ecd
ref: Hajizadeh2018doessocioeconomic
times-cited: '9'
title: Does socioeconomic status affect lengthy wait time in Canada? Evidence from
  Canadian Community Health Surveys
type: article
unique-id: WOS:000428253700006
usage-count-last-180-days: '2'
usage-count-since-2013: '15'
volume: '19'
web-of-science-categories: Economics; Health Policy \& Services
year: '2018'