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

Int J Environ Res Public Health. 2022 May 24;19(11):6392. doi: 10.3390/ijerph19116392.

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: geographically weighted regression; osteoarthritis; primary care utilization; rural–urban differences.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Osteoarthritis*
  • Poverty
  • Primary Health Care
  • Rural Population*
  • Spatial Analysis

Grants and funding

This research was funded through the Arthur J.E. Child Chair in Rheumatology Research. D.M. was supported by the Arthur J.E. Child Chair in Rheumatology Research and a Canada Research Chair, Health Systems, and Services Research (2008-18). X.L. was supported by the Arthur J.E. Child Chair in Rheumatology Research, the Cumming School of Medicine Postdoctoral Scholarship and the Postdoctoral Scholarship funded by the O’Brien Institute of Public Health and the McCaig Institute for Bone and Joint Health.