An investigation of the impact of supplementary health benefits for low-income families in Saskatchewan

Objectives: To examine the changes in health service use by recipients of Family Health Benefits, a supplementary benefits program that was introduced to lower-income, working families in Saskatchewan beginning in July 1998. These benefits reduced or eliminated fees for prescription drugs and for chiropractic, optometric and dental services. Methods: The study population included program beneficiaries between July 1998 and January 2000. Administrative data maintained by Saskatchewan Health were used to capture information on changes in benefits coverage and use of hospital, physician, prescription drug, chiropractic and optometric services from 1997 to 2000. Demographic characteristics of the study population were described. Utilization rates were compared for periods prior to and following introduction of the program. Results: Almost three quarters of Family Health Benefit beneficiaries had not had any form of prior supplementary health coverage in the previous year. A large proportion of these beneficiaries lived in rural Saskatchewan. Distinct demographic characteristics were observed for rural and urban beneficiaries. While utilization of physician and hospitalization services was lower following the introduction of the program, utilization of prescription drugs, and both chiropractic and optometric services increased. Conclusions: The reduction in user fees for non-insured services resulted in an increased use of these health services, suggesting that user fees can act as a barrier to the use of medical services by low-income families.