SRF016: Describing inequities in health service utilization for persons living with dementia in rural and urban areas in Quebec
Geneviève Arsenault-Lapierre, PhD; Claire Godard-Sebillotte, MD, MSc; Tammy Bui, BSc, MSc; Nadia Sourial, MSc; Amelie Quesnel-Vallee; Isabelle Vedel, MD, PhD; Louis Rochette, MSc; Victoria Massamba, MPH
Persons living with dementia have higher healthcare utilization, but little is known about how rurality modulates this relationship. Rural residents are more likely to face barriers in obtaining health care, such as experiencing longer travel times, delayed referrals, and uneven healthcare resources compared with residents from more urban areas.
The aim of this study is to describe healthcare utilization across rural and urban persons living with dementia.
We used a repeated annual cross-sectional cohort design between 2000-2017.
Linked administrative databases from the Institut national de santé publique du Québec.
All incident cases of dementia in community-dwelling persons aged 65 and over occurring between April 1st and March 31st for each year were included. Dementia diagnosis was ascertained using a validated algorithm.
Rurality was defined by Statistical Area Classification (SAC) types, SACtype 1 being the most urban and SACtype 7 the most rural. SACtype 8 represents areas where physicians do not bill for services and health service utilization data is thus unavailable for this study.
We will present trends over 17 years in quality of care and healthcare utilization indicators for 237, 259 persons with dementia. Of these people, 79,8% live in urban areas (SACtype1-3), while 20,2% live in rural areas (SACtype 4-7). Indicators presented will be: emergency department visits, hospitalizations, alternate level of care, visits to primary care physicians and cognition specialists, long-term care admission and mortality.
Graphical and visual descriptive analyses for each indicator will close the knowledge gap by offering a description of health service use for community-dwelling persons living with dementia across a rurality spectrum.