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Exploring the Influence of Income and Geography on Access to Services for Older Adults in British Columbia: A Multivariate Analysis Using the Canadian Community Health Survey (Cycle 3.1)

Published online by Cambridge University Press:  03 March 2011

Diane E. Allan ,
Laura M. Funk ,
R. Colin Reid  and
Denise Cloutier-Fisher
Diane E. Allan*
Affiliation:
Centre on Aging, University of Victoria
Laura M. Funk
Affiliation:
Centre on Aging, University of Victoria
R. Colin Reid
Affiliation:
Health Studies, University of British Columbia Okanagan
Denise Cloutier-Fisher
Affiliation:
Centre on Aging and Department of Geography, University of Victoria
*
*Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Diane E. Allan, M.A. Centre on Aging, University of Victoria Sedgewick A, PO Box 1700 STN CSC Victoria, BC V8W 2Y2 ([email protected])
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Abstract

Existing research on the health care utilization patterns of older Canadians suggests that income does not usually restrict an individual’s access to care. However, the role that income plays in influencing access to health services by older adults living in rural areas is relatively unknown. This article examines the relationship between income and health service utilization among older adults in rural and urban areas of British Columbia. Data were drawn from Statistics Canada’s Canadian Community Health Survey, Cycle 3.1. Multivariate regression techniques were employed to examine the influence of relative income on accessibility for 3,424 persons aged 65 and over. Results suggest that (1) relative income does not influence access to health care services; and (2) this is true for both urban and rural older adults. The most important and consistent predictors of access in all cases were those that measured health care need.

Résumé

Les recherches existantes sur les modes d’utilisation des soins de santé des Canadiens âgés suggèrent que habituellement le revenu ne restreint pas l’accès d’une personne. Cependant, le rôle que joue le revenu en influençant l’accès aux services de santé par les personnes âgées vivant en milieux ruraux est relativement inconnu. Cet article examine la relation entre le revenu et l’utilisation des services de santé chez les personnes âgées dans les zones rurales et urbaines de la Colombie-Britannique. Les données ont été extraites de l’Enquête sur la santé dans les collectivités canadiennes (ESCC) de Statistique Canada, cycle 3.1. Avec une régression multivariable, on a examiné l’influence du revenu sur l’accessibilité de 3 424 personnes âgés de 65 ans et plus. Les résultats suggèrent que (1) de faible revenu n’influence pas l’accès aux services de soins de santé, et (2) que cela est vrai pour les adultes âgés urbaines et ruraux. Dans tous les cas, les prédicteurs les plus importants et cohérents d’accès sont ceux qui ont mesuré le besoin de soins de santé.

Keywords

accès aux soins de santésoins de santépersonnes âgéesrurale(s)-auxla Colombie-BritanniquerevenuESCC 3.1health care accesshealth servicesolder adultsruralBritish ColumbiaincomeCCHS 3.1
Type
Regular Articles / Articles réguliers
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 30 , Issue 1 , March 2011 , pp. 69 - 82
Copyright
Copyright © Canadian Association on Gerontology 2011

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References

Allan, D.E., & Cloutier-Fisher, D. (2006). Health services utilization of older adults in British Columbia: Making sense of geography. Canadian Journal on Aging, 25, 219–232.Google Scholar
Allan, D., & Penning, M.J. (2001). Regionalization and health service utilization among older adults: Rural-urban differences. Paper presented at the World Congress of Gerontology, Vancouver, British Columbia.Google Scholar
Andersen, R.M., & Newman, J.F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly, 51, 95–124.Google Scholar
Bay, K.S., & Maher, M. (1989). Utilization of hospital services by cardiovascular patients, Alberta, Canada. American Journal of Public Health, 79, 759–764.Google Scholar
Brunner, E., & Marmot, M. (2002). Social organization, stress, and health. In Marmot, M., & Wilkinson, R.G. (Eds.), Social determinants of health (pp. 17–43). Oxford: Oxford University Press.Google Scholar
Buske, L. (2000). Availability of services in rural areas. CMAJ, 18, 162.Google Scholar
Centre for Health Services and Policy Research. (2002). The British Columbia health atlas (1st ed.). Vancouver, British Columbia, Canada: Centre for Health Services and Policy Research.Google Scholar
Chappell, N.L., Gee, E., McDonald, L., & Stone, M. (2003). Aging in contemporary Canada. Toronto, Ontario, Canada: Prentice Hall.Google Scholar
Cloutier-Fisher, D., Penning, M., Zheng, C., & Druyts, E. (2006). The devil is in the details: Trends in avoidable hospitalization rates by geography in British Columbia, 1990-2000. BMC Health Services Research, 6, 104.Google Scholar
Cloutier-Fisher, D., & Skinner, M. (2006). Leveling the playing field? Exploring the implications of managed competition for voluntary sector providers of long-term care in small town Ontario. Health & Place, 12, 97–109.Google Scholar
Cott, C.A., Gignac, M.A.M., & Badley, E.M. (1999). Determinants of self rated health for Canadians with chronic disease and disability. Journal of Epidemiology & Community Health, 53, 731–736.CrossRefGoogle Scholar
Coyte, P., Evans, R., Barer, S., & Marmor, T. (1995). Why are some people healthy and others not? The determinants of health of populations. Canadian Journal of Economics, 28, 928–941.Google Scholar
Dansky, K.H., Brannon, D., Shea, D., Vasey, J., & Dirani, R. (1998). Profiles of hospital, physician, and home health service use by older persons in rural areas. Gerontologist, 38, 320–330.Google Scholar
Dorly, J., Deeg, H., & Bath, P.A. (2003). Self-rated health, gender, and mortality in older persons: Introduction to a special section. Gerontologist, 43, 369–371.Google Scholar
Evans, R.G., & Stoddart, G.L. (1990). Producing health, consuming health care. Social Science & Medicine, 31, 1347–1363.Google Scholar
Evashwick, C., Rowe, G., Diehr, P., & Branch, L. (1984). Factors explaining the use of health care services by the elderly. Health Services Research, 19, 357–382.Google Scholar
Fakhoury, W.K.H., & Roos, L. (1996). Access to and use of physician resources by the rural and urban populations in Manitoba. The Canadian Journal of Public Health, 87, 248–252.Google Scholar
Finkelstein, M.M. (2001). Do factors other than need determine utilization of physician’ services in Ontario? CMAJ, 165, 565–570.Google Scholar
Furlong, W., Feeny, D., Torrance, G.W., Goldsmith, C., DePauw, S., Boyle, M., et al. . (1998). Multiplicative Multi-attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report. McMaster University Centre for Health Economics and Policy Analysis Working Paper No. 98-11. Hamilton, Ontario, Canada: McMaster University.Google Scholar
Gesler, W.M., Savitz, L.A., & Wittie, P.S. (1998). Methods for assessing geographic aspects of health care for older adults in rural areas. In Gesler, W.M., Rabiner, D.J., & DeFriese, G.H. (Eds.), Rural health and aging research: Theory, methods and practical applications (pp. 43–66). Amityville, NY: Baywood Publishing Company, Inc.Google Scholar
Hodge, G. (2008). The geography of aging: Preparing communities for the surge in seniors. Montreal, Quebec, Canada: McGill-Queen’s University Press.Google Scholar
Horsman, J., Furlong, W., Feeny, D., & Torrance, G. (2003). The Health Utilities Index (HUI): Concepts, measurement properties and applications. Health and Quality of Life Outcomes, 1, 54.Google Scholar
House, J., Lepkowski, J.M., Kinney, A.M., Mero, R.P., Kessler, R.C., & Herzog, A.R. (1994). The social stratification of aging and health. Journal of Health & Social Behavior, 35, 213–234.Google Scholar
Joseph, A.E., & Phillips, D.R. (1984). Accessibility and utilization: Geographic perspectives on health care delivery. New York: Harper and Row.Google Scholar
Keating, N.C. (1991). Aging in rural Canada. Toronto, Ontario, Canada: Butterworths.Google Scholar
Kirby, M.J., & LeBreton, M. (2002). The health of Canadians - the federal role. Volume 2: Current trends and future challenges. Ottawa, Ontario, Canada: The Standing Senate Committee on Social Affairs. Science and Technology, Parliament of Canada.Google Scholar
Lin, G., 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, 2037–2053.Google Scholar
Marmot, M., & Wilkinson, R.G. (2002). Social determinants of health. Oxford: Oxford University Press.Google Scholar
Martin Matthews, A. (1988). Variations in the conceptualization and measurement of rurality: Conflicting findings on the elderly widowed. Journal of Rural Studies, 4, 141–150.Google Scholar
Martin, D., Wrigley, H., Barnett, S., & Roderick, P. (2002). Increasing the sophistication of access measurement in a rural healthcare study. Health & Place, 8, 3–13.Google Scholar
Millman, M. (Ed.). (1993). Access to health care in America. Washington, DC: National Academy Press.Google Scholar
Newbold, K.B., Eyles, J., & Birch, S. (1995). Equity in health care: Methodological contributions to the analysis of hospital utilization within Canada. Social Science & Medicine, 40(9), 1181–1182.Google Scholar
Newbold, K.B., Eyles, J., Birch, S., & Spencer, A. (1998). Allocating resources in health care: Alternative approaches to measuring needs in resource allocation formula in Ontario. Health & Place, 4(1), 79–89.Google Scholar
Parker, E.B., & Campbell, J.L. (1998). Measuring access to primary medical care: Some examples of the use of geographical information systems. Health & Place, 4, 183–193.Google Scholar
Peacock, D., Devlin, N., & McGee, R. (1999). The horizontal equity of health care in New Zealand. Australian and New Zealand Journal of Public Health, 23, 126–130.Google Scholar
Ricketts, T.C., Randolph, R., Howard, H.A., Pathman, D., & Carey, T. (2001). Hospitalization rates as indicators of access to primary care. Health & Place, 7, 27–38.Google Scholar
Romanow, R. (2002). Commission on the future of health care in Canada: Final report. Ottawa, Ontario, Canada: Health Canada.Google Scholar
Roos, N., Burchill, C., & Carriere, K. (2003). Who are the high hospital users: A Canadian case study. Journal of Health Services Research & Policy, 8, 5–10.Google Scholar
Sin, D.D., Svenson, L.W., Cowie, R.L., & Man, S.F. (2003). Can universal access to health care eliminate health inequities between children of poor and nonpoor families?: A case study of childhood asthma in Alberta. Chest, 124, 51–56.Google Scholar
Statistics Canada. (2005). Canadian community health survey, cycle 3.1 microdata files. Ottawa, ON: Statistics Canada, Government of Canada.Google Scholar
Statistics Canada. (2006). Canadian community health survey, cycle 3.1 documentation. Ottawa, ON: Statistics Canada, Government of Canada.Google Scholar
Strain, L.A. (1990). Physician visits by the elderly: Testing the Andersen-Newman Framework. Canadian Journal of Sociology, 15, 19–37.Google Scholar
Stuart, B., & Shea, D. (1996). Urban/rural differences in the elderly’s use of health care. Final report, Grant R01-AG11820, US: 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, DS84–DS99.Google Scholar
Veugelers, P.J., & Yip, A.M. (2003). Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health? Journal of Epidemiology & Community Health, 57, 424–428.Google Scholar
Wilkinson, R.G. (1997). Health inequalities: Relative or absolute material standards? BMJ, 314, 591–595.Google Scholar