Chronic Diseases and Injuries in Canada

Volume 31 · Supplement 1 · Fall 2011

Patterns of Health Services Utilization in Rural Canada

https://doi.org/10.24095/hpcdp.31.S1.01

Table of contents

• Introduction
  • Context of this study
  • Framework for analyzing health services utilization
  • The framework’s elements
  • Objectives of this study
• Methods
  • Defining “rural”
  • Data sources and analytical methods
  • General statistical notes
• Results
  • National overview: access to and utilization of health care services
  • Provincial patterns in health care resources and utilization
  • Utilization patterns by disease in three provinces
• Discussion and conclusion
  • “Rural” is not a unitary concept
  • Different patterns of service delivery
  • The health care system and rural health
  • Reasons for regional variations in utilization
  • The role of “place” in health
  • Where do we go from here?
• Acknowledgments
• References
• Appendices
  • Appendix 1 Glossary
  • Appendix 2 provincial patterns by disease: detailed tables

List of tables

• Table 1 – Canadian population by degree of rurality, 1996 and 2001
• Table 2 – Groupings of physician specialties used in the analysis of physician claims
• Table 3 – Diagnoses used to compare relative risks of physician visits and hospitalizations for urban and rural populations
• Table 4 – Number of physicians and physician-to-population ratios per 10 000, by physician type and place of residence, 2001
• Table 5 – Age-standardized proportions of Canadians aged 12 years and over who reported having consulted a doctor in the previous 12 months, by place of residence, 2000–2001
• Table 6 – Age-standardized proportions of individuals 15 years of age or over who reported consultations with dentists, nurses and other health services providers, by place of residence and sex, Canada, 2000–2001
• Table 7 – Age-standardized hospital discharge rates per 1000, by place of residence and sex, 2001–2002
• Table 8 – Average length of in-patient hospital stay (in days), by age group, sex and place of residence, Canada, 2001–2002
• Table 9 – Adjusted odds ratios for the association between place of residence and hospitalization in the previous 12 months, 2000–2001
• Table 10 – Age-standardized proportions of Canadians 15 years of age or over asked about the quality of and satisfaction with selected health care services received in the previous 12 months, by place of residence and sex, 2000–2001
• Table 11 – Population by degree of rurality, Nova Scotia, Ontario and British Columbia, 2001
• Table 12 – Summary of relative risks of physician visits and hospitalizations attributed to selected disease categories, by place of residence and sex, Nova Scotia, 2001–2002
• Table 13 – Relative risks of age-standardized physician visits for mental disorders and injuries and poisonings, by place of residence and sex, Nova Scotia, 2001–2002
• Table 14 – Relative risks of age-standardized discharge from hospital for mental disorders, by place of residence and sex, Nova Scotia, 2001–2002
• Table 15 – Summary of relative risks of physician visits and hospitalizations attributed to selected disease categories, by place of residence and sex, Ontario, 2001–2002
• Table 16 – Relative risks of age-standardized physician visits for injuries and poisonings, by place of residence and sex, Ontario, 2001–2002
• Table 17 – Relative risks of age-standardized discharge from hospitals for mental disorders, by place of residence and sex, Ontario, 2001–2002
• Table 18 – Summary of relative risks of physician visits and hospitalizations attributed to selected disease, by place of residence and sex, British Columbia, 2001–2002

List of figures

• Figure 1 – An adaptation of the Emerging Behavioural Model of people’s use of health services
• Figure 2 – Age-standardized proportions of Canadians 12 years of age or over who required access to routine or ongoing health care services, by place of residence, 2000–2001
• Figure 3 – Age-standardized proportions of Canadians 15 years of age or over who required access to immediate health services for minor health problems in the past year, by place of residence, 2000–2001
• Figure 4 – Age-standardized proportions of Canadians 15 years of age or over who reported waiting for months to access specialized and non-emergency surgery, by place of residence, 2000–2001
• Figure 5 – Age-standardized proportions of Canadian men 12 years of age or over who reported using physician services in the past 12 months, by type of physician and place of residence, 2000–2001
• Figure 6 – Age-standardized proportions of women 12 years of age or over who reported using physician services in the past 12 months, by type of physician and place of residence, Canada, 2000–2001
• Figure 7 – Average annual age-standardized physician-visit rates for family physicians, per 1000, by place of residence and sex, Nova Scotia, biennial periods, 1997–2002
• Figure 8 – Average annual age-standardized physician-visit rates for medical specialists, per 1000, by place of residence and sex, Nova Scotia, biennial periods, 1997–2002
• Figure 9 – Average annual age-standardized physician-visit rates for surgical specialists, per 1000, by place of residence and sex, Nova Scotia, biennial periods, 1997–2002
• Figure 10 – Average annual age-standardized physician-visit rates for family physicians, per 1000, by place of residence and sex, Ontario, biennial periods, 1997–2002
• Figure 11 – Average annual age-standardized physician-visit rates for medical specialists, per 1000, by place of residence and sex, Ontario, biennial periods, 1997–2002
• Figure 12 – Average annual age-standardized physician-visit rates for surgical specialists, per 1000, by place of residence and sex, Ontario, biennial periods, 1997–2002

List of appendix tables

• Table A1 – Relative risks of age-standardized physician visits for circulatory system diseases, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A2 – Relative risks of age-standardized discharges from hospitals for circulatory system diseases, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A3 – Relative risks of age-standardized physician visits for cancers (neoplasms), by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A4 – Relative risks of age-standardized discharges from hospitals for cancers (neoplasms), by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A5 – Relative risks of age-standardized physician visits for respiratory system diseases, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A6 – Relative risks of age-standardized discharges from hospitals for respiratory diseases, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A7 – Relative risks of age-standardized physician visits for musculoskeletal system diseases, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A8 – Relative risks of age-standardized discharges from hospitals for musculoskeletal system disease, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A9 – Relative risks of age-standardized physician visits for injuries and poisonings, by place of residence and sex, Ontario and Nova Scotia, 2001–2002
• Table A10 – Relative risks of age-standardized discharges from hospitals for injuries and poisonings, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A11 – Relative risks of age-standardized physician visits for mental disorders, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A12 – Relative risks of age-standardized discharges from hospitals for mental disorders, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A13 – Relative risks of age-standardized physician visits for nervous system diseases, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001
• Table A14 – Relative risks of age-standardized discharges from hospitals for nervous system diseases, by place of residence and sex, Ontario, Nova Scotia and British Columbia, 2001–2002
• Table A15 – Relative risks of age-standardized physician visits for diabetes, by place of residence and sex, Ontario and Nova Scotia, 2001–2002, and British Columbia, 2000–2001