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Does Geography Matter? The Health Service Use and Unmet Health Care Needs of Older Canadians*

Published online by Cambridge University Press:  04 March 2010

James Ted McDonald  and
Heather Conde
James Ted McDonald*
Affiliation:
University of New Brunswick
Heather Conde
Affiliation:
University of New Brunswick
*
†Correspondence concerning this article should be addressed to / La correspondance concernant cet article doit être adressées à: James Ted McDonald, Department of Economics, University of New Brunswick, PO Box 4400 Fredericton, New Brunswick, Canada E3B 5A3 (tedmcdon@unb.ca)
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Abstract

The rising cost of health care and changing demographic profiles have resulted in the relocation and redistribution of funding and services between rural and urban areas. Most econometric analyses of Canada’s health service use include broad controls by province and rural/urban status, but relatively little econometric work has focused on geographical variation in health service use. Using the Canadian Community Health Survey 2.1, we examined determinants of various measures of health services use by Canadians aged 55 or older across a range of urban and rural areas of residence. Our regression analysis showed that older residents in rural areas made fewer visits to a general practitioner, to a specialist, and to a dentist relative to urban residents. All else being equal, there are no significant differences in hospital nights or in unmet healthcare needs. These differences are significant after controlling for demographic characteristics, socioeconomic status, private health insurance, and health status.

Résumé

Le coût croissant de soins de santé et le changement des profils démographiques ont entraîné le déplacement et la redistribution du financement et des services entre les zones rurales et urbaines. La plupart des analyses économétriques de l’utilisation de services de santé au Canada incluent des contrôles larges selon la province et l’état rural/urbain; mais relativement peu du travail économétrique a porté sur la variation géographique dans l’utilisation de services de santé. À l’aide de l’Enquête sur la santé dans les collectivités canadiennes (ESCC 2.1), nous avons examiné les déterminants de diverses mesures d’utilisation des services de santé par les Canadiens âgés de 55 ou plus d’une gamme de zones urbaines et rurales de résidence. Notre analyse de régression a montré que les anciens résidents dans les zones rurales font moins visites chez un omnipraticien, chez un spécialiste et chez un dentiste par rapport aux résidents urbains. Tout étant égal, il n’existe aucune différence significative parmi nuits passées à l’hôpital ou dans les besoins de soins de santé non satisfaits. Cependant, apres contrôle pour les caractéristiques démographiques, le statut socioéconomique, l’assurance santé privée et l’état de santé, ces différences sont importantes.

Keywords

utilisation de services de santédifférences rurales/urbainesles personnes agéesbesoins de soins de santé non satisfaitshealth service userural/urban differencesolder and aged individualsunmet health care needs
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 1: Special Issue from the Social and Economic Dimensions of an Aging Population Project (SEDAP) – Caring for an Aging Population: Context, Practice & Policy , March 2010 , pp. 23 - 37
Copyright
Copyright © Canadian Association on Gerontology 2010

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Footnotes

*

The authors thank Brian Ferguson, Logan McLeod, Carolyn Rosenthal, and Byron Spencer for helpful comments. Conde acknowledges financial support from a Social Sciences and Humanities Research Council master’s fellowship. McDonald acknowledges financial support from SSHRC through the Social and Economic Dimensions of an Aging Population (SEDAP) program at McMaster University. Analysis of confidential Canadian data was conducted at the Canadian Research Institute for Social Policy – University of New Brunswick (CRISP-UNB) Research Data Centre in Fredericton.

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