Equity in GP and specialist contacts by older persons in Belgium

Objectives To explore the existence of socioeconomic differences in probability and intensity of general practitioner(GP) and specialist contacts among the Belgian elderly population, compared with the younger population.Methods A nationally representative cross-sectional study based on 4,825 older (C65) and 14,738 younger participants(\65) in the Belgian Health Interview Surveys 2001 and 2004. Socioeconomic differences in contacts with a GP andspecialist were examined using two-part hurdle models; use versus nonuse by logistic regression, and intensity of use byzero-truncated negative binomial regression. Results The intermediate income group was more likely to contact a GP and tenants reported more GP contacts.Lower educated older persons were less likely to contact a specialist and household income seemed to play a role inthe intensity of specialist contacts.Conclusions The probability and intensity of general practitioner and specialist contacts among the Belgianolder population are mainly determined by sociodemographic and health status variables, but a certain degree ofinequity remains. The socioeconomic gradient differs in probability and intensity of contacts, indicating theadvantage of using a two-part model in investigating socioeconomic differences in healthcare utilisation.