Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-67gxp Total loading time: 1.035 Render date: 2021-03-01T19:38:20.426Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Health Service Utilization among Older Adults in British Columbia: Making Sense of Geography*

Published online by Cambridge University Press:  31 March 2010

Diane Allan
Affiliation:
Centre on Aging, University of Victoria
Denise Cloutier-Fisher
Affiliation:
Centre on Aging, University of Victoria
Corresponding
E-mail address:

Abstract

The utilization of health services by older adults has received increased attention over the past decade, but little is known about how service utilization varies between rural and urban areas. In an era of restructuring and downsizing within the Canadian health care system, there are concerns that rural older adults may be increasingly disadvantaged when it comes to accessing health care. This article examines the utilization of a range of health services by older adults living in urban and rural communities in British Columbia. A major strength of this article is its concurrent focus on a continuum of geographic communities and a broad range of services needed and used by older populations. The research utilizes provincial administrative health data from 48,407 older residents of British Columbia who used services in 1998–1999. Multivariate analyses of co-variance reveal some unique service utilization patterns by geographical area and population.

Résumé

L'utilisation des services de santé de la part des personnes âgées a fait l'objet d'une attention croissante au cours des dix dernières années, mais on ignore pratiquement tout sur la différence d'utilisation des services entre les milieux ruraux et urbains. En cette époque de restructuration et de réduction des effectifs à l'intérieur des systèmes de services de santé canadiens, d'aucuns estiment que les personnes âgées en milieu rural risquent d'être de plus en plus désavantagées en matière d'accès aux services. Cet article se penche sur l'utilisation d'une gamme de services de santé de la part des personnes âgées qui vivent dans des communautés rurales ou urbaines de la Colombie Britannique. L'un des points de force de cet article, c'est qu'il centre également l'attention sur un continuum de communautés géographiques et sur une vaste gamme de services nécessaires utilisés par les populations plus âgées. La recherche se sert de données administratives provinciales provenant des services de santé de la Colombie Britannique concernant 48,407 personnes âgées ayant utilisé ces services en 1998–1999. Des analyses multivariées de covariance font ressortir des modèles particuliers d'utilisation des services en fonction de la géographie et de la population.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2006

Access options

Get access to the full version of this content by using one of the access options below.

Footnotes

*

The authors wish to thank Dr. Margaret J. Penning for use of the data collected as part of a larger study entitled Health Care Restructuring and Community-Based Care: A Longitudinal Study, supported by a grant (LOI 1997-054) from the Canadian Health Services Research Foundation, with contributions from the Capital Health Region and the Ministry of Health / Ministry Responsible for Seniors in British Columbia, the Manitoba Centre for Health Policy and Evaluation, and the South Eastman and Interlake Regional Health Authorities in Manitoba. In addition, the first author would like to acknowledge the support received from a Michael Smith Foundation for Health Research Senior Graduate Trainee Award. Finally, the authors would also like to thank the reviewers for their comments.

References

Anderson, G.M. (1997). Hospital restructuring and the epidemiology of hospital utilization: Recent experience in Ontario. Medical Care, 35(10 Suppl.), OS93OS101.CrossRefGoogle ScholarPubMed
Barer, M.L., Evans, R.G., & Hertzman, C. (1995). Avalanche or glacier? Health care and the demographic rhetoric. Canadian Journal on Aging, 14, 193224.CrossRefGoogle Scholar
BC Ministry of Health and Ministry Responsible for Seniors. (1991). Closer to home (Report of the Royal Commission on Health Care and Costs). Victoria, BC: Author.Google Scholar
Béland, F., LeMay, A., Philibert, L., Maheux, B., & Gravel, G. (1991). Elderly patients' use of hospital-based emergency services. Medical Care, 29(4), 408418.CrossRefGoogle ScholarPubMed
Benoit, C., Carroll, D., & Millar, A. (2002). But is it good for non-urban women's health? Canadian Review of Sociology and Anthropology, 39(4), 373395.CrossRefGoogle Scholar
Black, C., Roos, N.P., Havens, B., & MacWilliam, L. (1995). Rising use of physician services by the elderly: The contribution of morbidity. Canadian Journal on Aging, 14, 225244.CrossRefGoogle Scholar
Black, C., & Burchill, C. (1999). An assessment of the potential for repatriating care from urban to rural Manitoba. Medical Care, 37(6), JS167JS186.CrossRefGoogle ScholarPubMed
Burke, M., & Stevenson, H.M. (1998). Fiscal crisis and restructuring in medicare: The politics of health in Canada. In Coburn, D., D'Arcy, C., & Torrence, G.M. (Eds.), Health and Canadian society: Sociological perspectives (3rd ed.; pp. 597618). Toronto, ON: University of Toronto Press.Google Scholar
Canadian Institute for Health Information. (1998). National health expenditure trends, 1975–1998. Ottawa, ON: Author.Google Scholar
Cabeides, L., & Guillen, A. (2001). Adopting and adapting managed competition: Health care reform in Southern Europe. Social Science and Medicine, 52, 12051217.CrossRefGoogle Scholar
Canadian Medical Association. (2003). The development of a multistakeholder framework/Index of rurality (Final report to Health Canada: Rural and Remote Innovations Initiative). Retrieved 20 April 2006 from http://cna-aiic.ca/CNA/documents/pdf/publications/Final_Report_e.pdf.Google Scholar
Centre for Health Services and Policy Research. (2002). The British Columbia health atlas (1st ed.). Vancouver: Author.Google Scholar
Chalifoux, Z., Neese, J.B., Buckwalter, K.C., Litwak, E., & Abraham, I. (1996). Mental health strategies for rural elderly: Innovative service strategies. Community Mental Health Journal, 32(5), 463480.CrossRefGoogle ScholarPubMed
Chamberlayne, R., Green, B., Barer, M., Hertzman, C., Lawrence, W.J., & Sheps, S.B. (1998). Creating a population-based linked health database: A new resource for health services research. Canadian Journal of Public Health, 89, 270273.Google ScholarPubMed
Cheal, D. (2000). Aging and demographic change. Canadian Public Policy, 27(2), S109S122.CrossRefGoogle Scholar
Church, J., & Barker, P. (1998). Regionalization of health services in Canada: A critical perspective. International Journal of Health Services, 28(3), 467486.CrossRefGoogle ScholarPubMed
Cloutier-Fisher, D., & Joseph, A.E. (2000). Long-term care restructuring in rural Ontario: Retrieving community service user and provider narratives. Social Science and Medicine, 50, 10371045.CrossRefGoogle ScholarPubMed
Cohen, M.M., & MacWilliam, L. (1995). Measuring the health of the population. Medical Care, 33(12), DS21DS42.CrossRefGoogle ScholarPubMed
Dansky, K.H., Brannon, D., Shea, D.G., Vasey, J., & Dirani, R. (1998). Profiles of hospital, physician, and home health care service use by older persons in rural areas. Gerontologist, 38(3), 320330.CrossRefGoogle ScholarPubMed
DeCoster, C., & Brownell, M. (1997). Private health care in Canada: Saviour or siren? Public Health Reports, 112(4), 298305.Google ScholarPubMed
du Plessis, V., Beshiri, R., & Bollman, R.D. (2001). Definitions of “rural”. Ottawa, ON: Statistics Canada, Agriculture Division.Google Scholar
Evans, R.G., McGrail, K.M., Morgan, S.G., Barer, M.L., & Hertzman, C. (2001). Apocalypse no: Population aging and the future of health care systems. Canadian Journal on Aging, 20(1), 160191.CrossRefGoogle Scholar
Fakhoury, W.K.H., & Roos, L. (1996). Access to and use of physician resources by the rural and urban populations in Manitoba. Canadian Journal of Public Health, 87(4), 248252.Google Scholar
Furuseth, O.J. (1998). Service provision and social deprivation. In Ilbery, B. (Ed.), Geography of rural change (pp. 233256). Essex, UK: Longman.Google Scholar
Gesler, W.M., Rabiner, D.J., & DeFriese, G.H. (1998). Introduction to research on rural health and aging issues. In Gesler, W.M., Rabiner, D.J., & DeFriese, G.H. (Eds.), Rural health and aging research: Theory, methods and practical applications (pp. 113). New York, NY: Baywood.Google Scholar
Hair, J.F., Anderson, R.E., Tatham, R.L., & Black, W.C. (1998). Multivariate data analysis (5th ed.). Upper Saddle River, NJ: Prentice-Hall.Google Scholar
Hollander, M.J., & Pallan, P. (1995). The British Columbia continuing care system: Service delivery and resource planning. Aging: Clinical and Experimental Research, 7(2), 94109.Google ScholarPubMed
Hodge, G. (1998). Planning Canadian communities: An introduction to the principles, practice and participation (3rd ed.). Scarborough, ON: ITP Nelson.Google Scholar
Janus Project. (1998). National family physicians survey 1997/98. College of Family Physicians of Canada. Retrieved October 2003 from www.cfpc.ca/english/cfpc/research/janus%20project/nfps/regional/bc/default.asp?s=1.Google Scholar
Joseph, A.E., & Cloutier, D.S. (1990). A framework for modeling the consumption of health services by the rural elderly. Social Science and Medicine, 30(1), 4552.CrossRefGoogle ScholarPubMed
Joseph, A.E., & Phillips, D. (1984). Accessibility and utilization: Geographic perspectives on health care delivery. New York, NY: Harper.Google Scholar
Kralj, B. (2000). Measuring “rurality” for purposes of healthcare planning: An empirical measure for Ontario. Ontario Medical Review, 67(9), 3349.Google Scholar
Leduc, E. (1997). Defining rurality: A general practice rurality index for Canada. Canadian Journal of Rural Medicine, 2(3), 125131.Google Scholar
Lin, G.E., Allan, D.E., & Penning, M.J. (2002). Examining distance effects on hospitalizations using GIS: A study of three health regions in British Columbia, Canada. Environment and Planning A, 34, 20372053.CrossRefGoogle Scholar
Liu, L., Hader, J., Brossart, B., White, R., & Lewis, S. (2001). Impact of rural hospital closures in Saskatchewan, Canada. Social Science and Medicine, 52, 17931804.CrossRefGoogle ScholarPubMed
Martin Matthews, A. (1988). Aging in rural Canada. In Rathbone-McCuan, E. and Havens, B. (Eds.), North American elders: United States and Canada (pp. 142160). Westport, CT: Greenwood Press.Google Scholar
Millman, M. (Ed.). (1993). Access to health care in America. Washington, DC: National Academy Press.Google Scholar
Northcott, H.C., & Milliken, P.J. (1998). Aging in British Columbia. Calgary, AB: Detselig Enterprises.Google Scholar
Penning, M. (2002). The health care of the elderly: From institutional care to home and community care. In Bolaria, B. Singh and Dickinson, H.D. (Eds.), Health, illness and health care in Canada (3rd ed.; pp. 292308). Canada: Nelson Thomson.Google Scholar
Penning, M.J., Allan, D.E., & Roos, L.L. (2002). Health care restructuring and community-based care: Three regions in British Columbia. Victoria, BC: Centre on Aging, University of Victoria.Google Scholar
Penning, M.J., & Keating, N.C. (2000). Self-, informal and formal care: Partnerships in community-based and residential long-term care settings. Canadian Journal on Aging, 19(Suppl. 1), 75100.CrossRefGoogle Scholar
Rice, J.J., & Prince, M.J. (2000). Changing politics of Canadian social policy. Toronto, ON: University of Toronto Press.Google Scholar
Roos, N.P., Shapiro, E., & Roos, L.L. (1984). Aging and the demand for health care services: Which aged and whose demand? Gerontologist, 24, 3136.CrossRefGoogle ScholarPubMed
Rosenberg, M.W., & James, A.M. (2000). Medical services utilization patterns by seniors. Canadian Journal on Aging, 19(Suppl. 1), 125142.CrossRefGoogle Scholar
Shapiro, E., & Havens, B. (2000). Bridging the knowledge gap: From evidence to policy and practice that fosters seniors' independence. Canadian Journal on Aging, 19(Suppl. 1), 176190.CrossRefGoogle Scholar
Skinner, M.W., & Rosenberg, M.W. (2002). Health care in rural communities: Exploring the development of informal and voluntary care (SEDAP research paper, No. 79). Hamilton, ON: Program for Research on Social and Economic Dimensions of an Aging Population, McMaster University.Google Scholar
Statistics Canada. (1996). Census of Canada, 1996: Profile of census tracts—CMA. Ottawa: Author.Google Scholar
Stuart, B., & Shea, D. (1996). Urban/rural differences in the elderly's use of health care (Final report, Grant R01-AG11820). Bethesda, MD: National Institute on Aging.Google Scholar
Tataryn, D.J., Roos, N.P., & Black, C.D. (1995). Utilization of physician resources for ambulatory care. Medical Care, 33(12), DS84DS99.CrossRefGoogle ScholarPubMed
Troughton, M. (1999). Redefining “rural” for the twenty-first century. In Ramp, W., Kulig, J., Townshend, I., & McGowan, V. (Eds.), Health in rural settings: Contexts for action (pp. 2138). Lethbridge, AB: University of Lethbridge.Google Scholar
Vancouver Island Health Authority. (2002). Health services redesign plan, 2002/03–2004/05. Victoria, BC: Author.Google Scholar
Wilkins, K., & Park, E. (1998). Home care in Canada. Health Reports, 10(1), 2937.Google Scholar
Williams, A.P., Deber, R., Baranek, P., & Gildiner, A. (2001). From medicare to home care: Globalization, state retrenchment, and the profitization of Canada's health-care system. In Armstrong, P., Armstrong, H., & Coburn, D. (Eds.), Unhealthy times: Political economy perspectives on health and care in Canada (pp. 730). Toronto, ON: Oxford University Press.Google Scholar
Wolinsky, F.D., & Johnson, R.J. (1991). The use of health services by older people. Journal of Gerontology, 46, S345S357.CrossRefGoogle Scholar

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 81 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 1st March 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Health Service Utilization among Older Adults in British Columbia: Making Sense of Geography*
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Health Service Utilization among Older Adults in British Columbia: Making Sense of Geography*
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Health Service Utilization among Older Adults in British Columbia: Making Sense of Geography*
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *