The nature of Cu2+ inhibition of photosystem 11 (PSII)

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health care is under provincial jurisdiction, the federal government provides provinces with financial incentives to realize these goals. As such, income level should have no effect on utilization of insured medical services. Despite this, Alter and colleagues 2 have published Canadian data demonstrating that higher socioeconomic status (SES) was a significant predictor of angiography use in the first 90 days after acute myocardial infarction in a large cohort (n = 47 036). In contrast, Shortt and colleague 3 reviewed over 39 000 elective surgeries conducted in 2 Ontario hospitals and found no difference in wait times between SES tertiles.In Sweden in 1997 Olsson 4 conducted a national survey of private and public hospitals that demonstrated large, unexpected variations in per capita utilization of CT and MRI that were not easy to explain in a country with a relatively homogenous, publicly funded health care system. Olsson postulated that these findings may have been due to regional variation in use, patient demographic characteristics, physician reimbursement patterns, physician research interests and "other sociodemographic factors."Frohlich and colleagues 5 published Manitoba data demonstrating that the per capita utilization of CT was positively correlated (r = 0.61, p = 0.001) with premature mortality rates, which is the rate of death among people under the age of 70. The premature mortality rate is an indicator of morbidity and expected health care needs. However, an inverse relation was demonstrated for MRI (r = -0.45, p = 0.024), which indicated that factors other than expected health care needs may drive MRI utilization.Apart from the studies cited above, a literature search (Ovid MEDLINE 1966 to June 4, 2003 found few studies on SES and specific diagnostic imaging modalities. Published studies tend to concentrate on diagnostic imaging screening programs such as mammography. [6][7][8][9] We sought to explore the association between utilization of selected diagnostic imaging modalities and SES. We postulated that population groups with higher SES may demonstrate greater utilization of more sophisticated technologies such as CT and MRI, with the converse being true for less sophisticated diagnostic imaging modalities such as routine radiography or ultrasound. The rationale is that people in higher SES groups may be more likely to have a regular family Socioeconomic status and the utilization of diagnostic imaging in an urban settingBackground: In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been examined in Canada relative to surgical, cardiac and preventive health care services, no published studies have specifically explored the association between SES and diagnostic imaging. Methods:We examined over 300 000 diagnostic imaging claims made in the Winnipeg Regional Health Authority between Apr. 1, 2001, and Mar. 31, 2002. Using patient posta...

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