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Int J Public Health. 2013 Aug;58(4):593-602. doi: 10.1007/s00038-012-0431-4. Epub 2012 Dec 1.

Equity in GP and specialist contacts by older persons in Belgium.

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Research Group Medical Sociology and Health Policy, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Belgium.



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.


A nationally representative cross-sectional study based on 4,825 older (≥65) and 14,738 younger participants (<65) in the Belgian Health Interview Surveys 2001 and 2004. Socioeconomic differences in contacts with a GP and specialist were examined using two-part hurdle models; use versus nonuse by logistic regression, and intensity of use by zero-truncated negative binomial regression.


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 in the intensity of specialist contacts.


The probability and intensity of general practitioner and specialist contacts among the Belgian older population are mainly determined by sociodemographic and health status variables, but a certain degree of inequity remains. The socioeconomic gradient differs in probability and intensity of contacts, indicating the advantage of using a two-part model in investigating socioeconomic differences in healthcare utilisation.

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