A recent comparative study of access to health care services reveals inequities in access to care along rural/urban lines in Canada.
A cross-sectional study was conducted across 10 provinces using data from the Canadian Community Health Survey (CCHS). The study compared five different measures of access and utilization across a continuum of rural-urban areas in Canada: having had an influenza vaccination in the previous two years; having seen a family physician in the previous 12 months; having seen a specialist physician (other than an eye doctor) in the previous 12 months; self-perceived unmet need in the previous 12 months; and having a regular medical doctor. The authors also controlled for other variables, such as location of residence at the levels of province, health region and community.
After adjusting for several mitigating factors, the authors found that:
- People living in the most urban centres were more likely to have seen a specialist,
- Those in rural communities had a lower chance of receiving a flu shot and having a regular medical doctor, and
- People in any of the rural categories were less likely to report unmet needs.
The authors point out that inequity to access in care along the rural-urban continuum can be masked when an evaluation is done at a very large scale using gross indicators, rather than specific measures of access and utilization.
See “An Evaluation of Access to Health Care Services along the Rural-Urban Continuum in Canada,” BMC Health Services Research (January 31, 2011; 11[20]), available at www.biomedcentral.com.