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Access and utilization: A continuum of health service environments

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  • Rosenberg, Mark W.
  • Hanlon, Neil T.

Abstract

Birch and Abelson [1] argue that non-income based barriers might explain differences in utilization of health services within and between income groups. Databases which contain utilization data rarely allow for the modelling of geographic variation. In the Ontario Health Survey (OHS), individual observations are georeferenced at the Public Health Unit (PHU) scale, but PHUs cannot easily be used because of the large coefficients of variation. To overcome this problem, a cluster analysis is performed to create a service environment variable, which reflects differences in service availability, population size and rurality. Utilization of health services is then modelled as a logistic regression equation where the independent variables are age, sex, service environment and income to test the Birch and Abelson argument. This argument is then extended by controlling for age, health and income status. Based on the modelling results, the importance of geography to access and utilization is assessed.

Suggested Citation

  • Rosenberg, Mark W. & Hanlon, Neil T., 1996. "Access and utilization: A continuum of health service environments," Social Science & Medicine, Elsevier, vol. 43(6), pages 975-983, September.
    • Handle: RePEc:eee:socmed:v:43:y:1996:i:6:p:975-983
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    Citations

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    Cited by:

    1. Hanlon, Neil & Skedgel, Chris, 2006. "Cross-district utilization of general hospital care in Nova Scotia: Policy and service delivery implications for rural districts," Social Science & Medicine, Elsevier, vol. 62(1), pages 145-156, January.
    2. François Rivest & Pascal Bossé & Silviu Nedelca & Alain Simard, 1999. "Access to Physician Services in Quebec: Relative Influence of Household Income and Area of Residence," Canadian Public Policy, University of Toronto Press, vol. 25(4), pages 453-481, December.
    3. Danxian Wu & Xiaolu Gao & Zhifei Xie & Zening Xu, 2021. "Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective," IJERPH, MDPI, vol. 18(2), pages 1-15, January.
    4. Huixia Liu & Linxiu Zhang & Gale Summerfield & Yaojiang Shi, 2009. "A gendered view of reforming health care access for farmers in China," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 1(2), pages 194-211, January.
    5. Wang, Lu & Rosenberg, Mark & Lo, Lucia, 2008. "Ethnicity and utilization of family physicians: A case study of Mainland Chinese immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 67(9), pages 1410-1422, November.

    More about this item

    Keywords

    access utilization health services;

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