Abstract
Objectives
To examine the changes in health service use by recipients of Family Health Benefits, a supplementary benefits program that was introduced to lower-income, working families in Saskatchewan beginning in July 1998. These benefits reduced or eliminated fees for prescription drugs and for chiropractic, optometric and dental services.
Methods
The study population included program beneficiaries between July 1998 and January 2000. Administrative data maintained by Saskatchewan Health were used to capture information on changes in benefits coverage and use of hospital, physician, prescription drug, chiropractic and optometric services from 1997 to 2000. Demographic characteristics of the study population were described. Utilization rates were compared for periods prior to and following introduction of the program.
Results
Almost three quarters of Family Health Benefit beneficiaries had not had any form of prior supplementary health coverage in the previous year. A large proportion of these beneficiaries lived in rural Saskatchewan. Distinct demographic characteristics were observed for rural and urban beneficiaries. While utilization of physician and hospitalization services was lower following the introduction of the program, utilization of prescription drugs, and both chiropractic and optometric services increased.
Conclusions
The reduction in user fees for non-insured services resulted in an increased use of these health services, suggesting that user fees can act as a barrier to the use of medical services by low-income families.
Résumé
Objectifs
Analyser l’évolution de l’utilisation des services de santé par les bénéficiaires des Prestations familiales de maladie de la Saskatchewan, un programme d’allocations complémentaires auquel ont accès depuis juillet 1998 les familles à faible revenu qui travaillent. Ces prestations ont réduit ou éliminé les frais des médicaments sur ordonnance et les frais des services de chiropractie, d’optométrie et de soins dentaires.
Méthode
La population à l’étude comprenait les bénéficiaires du programme entre juillet 1998 et janvier 2000. Les données administratives du ministère de la Santé de la Saskatchewan ont servi à saisir l’information sur les changements concernant la protection et le recours aux hôpitaux, aux médecins, aux médicaments sur ordonnance et aux services de chiropractie et d’optométrie entre 1997 et 2000. Le profil démographique de la population à l’étude est fourni. Les taux d’utilisation ont été comparés à ceux des périodes antérieure et postérieure au lancement du programme.
Résultats
Près des trois quarts des bénéficiaires des Prestations familiales de maladie ne jouissaient d’aucune protection médicale complémentaire l’année précédente. Une vaste proportion des bénéficiaires vivait en milieu rural. Les bénéficiaires des milieux ruraux et urbains affichaient un profil démographique distinct. Le recours aux services médicaux et hospitaliers a diminué après le lancement du programme, mais l’utilisation des médicaments sur ordonnance et des services de chiropractie et d’optométrie s’est accrue.
Conclusions
La réduction des frais modérateurs pour les services inassurés a entraîné une hausse dans l’utilisation de ces services, ce qui porte à croire que les frais modérateurs font obstacle à l’utilisation des services de santé dans les familles à faible revenu.
Footnotes
Acknowledgements: This project was supported by a financial contribution from the Health Transition Fund, Health Canada. Data, office and computer facilities were contributed by Saskatchewan Health and Saskatchewan Social Services. The views expressed herein do not necessarily represent the official policy of the federal or provincial governments.
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