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

Published online by Cambridge University Press:  31 March 2010

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


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.


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.

Copyright © Canadian Association on Gerontology 2006

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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.


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