The effect of socioeconomic status on access to primary care: an audit study

Michelle E. Olah; Gregory Gaisano; Stephen W. Hwang

doi:10.1503/cmaj.121383

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Re:Socioeconomic status as a predictive variable for appointment keeping
Irwin Corobow

Posted on: 11 April 2013
Socioeconomic status as a predictive variable for appointment keeping
James I. Hymas

Posted on: 06 March 2013

Posted on: (11 April 2013)

Re:Socioeconomic status as a predictive variable for appointment keeping
Irwin Corobow, Executive Director
The author of the response to this article has included a fairly sweeping characterization of persons of low socio economic status " it's because as a group they may be described as disorganized, easily distracted, unreliable and less likely than middle-class bank employees to keep doctor's appointments after having made them".
As an investment counselor I am certain the author would have very little, if any, c...
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The author of the response to this article has included a fairly sweeping characterization of persons of low socio economic status " it's because as a group they may be described as disorganized, easily distracted, unreliable and less likely than middle-class bank employees to keep doctor's appointments after having made them".
As an investment counselor I am certain the author would have very little, if any, contact, with persons of low socio economic status. So I would be interested if he would quote his scientific source for this characterization.
As a second generation Canadian I can attest to the fact that my grandparents (and many others) arrived in Canada with a low socio economic status. I would be very hesitant to have them described as "disorganized, easily distracted, unreliable". Clearly, the author's letter only serves to support the fact that discrimination, based on stupidity, is alive and well.
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (6 March 2013)

Socioeconomic status as a predictive variable for appointment keeping
James I. Hymas, Investment Counsellor
I take issue with the unsupported claim that there is an "absence of economic incentives" to "discriminate against people of low socioeconomic status".
While reimbursement by OHIP is unaffected by patients' socioeconomic status, it is affected to a very high degree by the question of whether the putative patient actually shows up for the appointment.
While the concept may cause some hand-wringing amon...
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I take issue with the unsupported claim that there is an "absence of economic incentives" to "discriminate against people of low socioeconomic status".
While reimbursement by OHIP is unaffected by patients' socioeconomic status, it is affected to a very high degree by the question of whether the putative patient actually shows up for the appointment.
While the concept may cause some hand-wringing among those who use the term "socioeconomic" with a straight face there is usually a reason why people of low socioeconomic status (defined in the paper as a "recipient of social assistance") are of low socioeconomic status: it's because as a group they may be described as disorganized, easily distracted, unreliable and less likely than middle-class bank employees to keep doctor's appointments after having made them. There are exceptions, to be sure. There are always exceptions.
A doctor who has scheduled time for an appointment not kept has suffered economic harm; thus, contrary to the paper's bald statement, there is economic incentive to make appointments with prospective patients most likely to keep them.
I am stunned that such an obvious rebuttal was not caught before publication. The authors may wish to apply for grants to study propensity to keep appointments by socioeconomic group.
Conflict of Interest:
None declared
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Competing Interests: None declared.