The Health Services Use Among Older Canadians in Rural and Urban Areas

Even though universal health care is one of the fundamental pillars of Canadian society, the rising cost of all services has resulted in the relocation and redistribution of funding and services between rural and urban areas. While most econometric analyses of health service use in Canada include broad controls by province and rural/urban status, there has been relatively little econometric work that has focused specifically on geographical variation in health service use. Using the 2002-03 wave of the Canadian Community Health Survey, we examine the determinants of a range of health services use by older Canadians across different types of urban and rural areas of residence. The regression analysis suggests two general conclusions: 1) other things equal, health service use is lower among older residents of rural areas in terms of visits to a GP, to a specialist and to a dentist compared to residents of urban core CMA/CAs, but there are no significant differences in hospital nights; and 2) these results are surprisingly robust across a range of specifications that control variously for demographic characteristics, socio-economic status, private health insurance, and physical health. However, the magnitude of the estimated differences is quantitatively not very large. In addition, the self-reported incidence of unmet healthcare needs overall shows no systematic variation across rural and urban areas.