The health services use among older Canadians in rural and urban areas. Social and Economic Dimensions of an Aging Population Research Paper 178

Although universal health care is one of the pillars of Canadian society, the rising cost of 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 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 a range of urban and rural areas of residence. The regression analysis suggests two general conclusions: 1) 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, ceteris paribus, but there are no significant differences in hospital nights; and 2) these results are robust across a range of specifications that control for demographic characteristics, socio-economic status, private health insurance, and physical health. However, the magnitude of the estimated differences is small. In addition, self-reported incidence of unmet healthcare needs overall shows no systematic variation across rural and urban areas