Income and regional gradients in being without a regular doctor: does the slope of gradients decrease for those with greater health needs?

OBJECTIVE Income and regional gradients in being without a regular family doctor have been reported. The study objective was to assess the extent to which the slopes of both income and regional gradients vary by individuals' health needs. METHOD Using the Canadian Community Health Survey and multivariate regression analyses, the study examined the income and interprovincial variations in potential access among the healthy and less healthy populations. RESULTS The presence of chronic conditions was associated with lower variations in income-related potential access, with the income gradient flattening at the second-lowest income category. Similarly, the presence of two or more chronic conditions flattened interprovincial variations in potential access. CONCLUSIONS The results suggest a greater equity in having a regular doctor on the basis of need. Systemic changes might be needed to enhance potential access among the vulnerable segment of the population.