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Year : 2021  |  Volume : 26  |  Issue : 2  |  Page : 69-79

Healthcare utilisation among Canadian adults in rural and urban areas – The Canadian Longitudinal Study on Aging

1 Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
2 Department of Geriatric Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
3 Department of Community Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
4 Department of Geography, University of Victoria, Victoria, British Columbia, Canada
5 Department of Psychology, Brandon University, Brandon, Manitoba, Canada
6 Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
7 Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence Address:
MD Philip St John
Department of Geriatric Medicine, University of Manitoba, Winnipeg, Manitoba
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/CJRM.CJRM_43_20

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Objective: The objective is to determine the use of health-care services (physician visits, emergency department use and hospitalisations) in rural areas and examine differences in four geographic areas on a rural to urban spectrum. Methods: We conducted a secondary analysis of cross-sectional data from a population-based prospective cohort study, the Canadian Longitudinal Study on Aging (CLSA). Participants included community-dwelling adults aged 45–85 years old from the tracking cohort of the CLSA (n = 21,241). Rurality was classified based on definitions from the CLSA sampling frame and similar to the 2006 census. Main outcome measures included self-reported family physician and specialist visits, emergency department visits and hospitalisations within the previous 12 months. Results were compared for four geographic areas on a rural-urban continuum. Univariate and bivariate analyses were performed on data from the 'tracking cohort' of the CLSA, Chi-square tests were used for categorical variables. Logistic regression models were created for the main outcome measures. Results: Participants in rural and mixed rural and urban areas were less likely to have seen a family physician or a specialist physician compared to urban areas. Those living in rural and peri-urban areas were more likely to visit an emergency department compared to urban areas. These differences persisted after adjusting for sociodemographic and health-related variables. There were no significant rural-urban differences in hospitalisations. Conclusion: Rural-urban differences were found in visits to family physicians, specialists and emergency departments.

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