Rural–Urban Differences in Non-Local Primary Care Utilization among People with Osteoarthritis: The Role of Area-Level Factors

Xiaoxiao Liu, Judy E. Seidel, Terrence McDonald, Nigel Waters, Alka B. Patel, Rizwan Shahid, Stefania Bertazzon and Deborah A. Marshall
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Xiaoxiao Liu: Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
Judy E. Seidel: Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
Terrence McDonald: O’Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada
Nigel Waters: O’Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada
Alka B. Patel: Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
Rizwan Shahid: O’Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada
Stefania Bertazzon: O’Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada
Deborah A. Marshall: Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada

IJERPH, 2022, vol. 19, issue 11, 1-24

Abstract: The utilization of non-local primary care physicians (PCP) is a key primary care indicator identified by Alberta Health to support evidence-based healthcare planning. This study aims to identify area-level factors that are significantly associated with non-local PCP utilization and to examine if these associations vary between rural and urban areas. We examined rural–urban differences in the associations between non-local PCP utilization and area-level factors using multivariate linear regression and geographically weighted regression (GWR) models. Global Moran’s I and Gi* hot spot analyses were applied to identify spatial autocorrelation and hot spots/cold spots of non-local PCP utilization. We observed significant rural–urban differences in the non-local PCP utilization. Both GWR and multivariate linear regression model identified two significant factors (median travel time and percentage of low-income families) with non-local PCP utilization in both rural and urban areas. Discontinuity of care was significantly associated with non-local PCP in the southwest, while the percentage of people having university degree was significant in the north of Alberta. This research will help identify gaps in the utilization of local primary care and provide evidence for health care planning by targeting policies at associated factors to reduce gaps in OA primary care provision.

Keywords: osteoarthritis; primary care utilization; rural–urban differences; geographically weighted regression (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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