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.

Study Design:
We used a repeated annual cross-sectional cohort design between 2000-2017.

Linked administrative databases from the Institut national de santé publique du Québec.

Population Studied:
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.

Outcome Measures:
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.

Expected Outcomes:
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.

Leave a Comment
Jack 11/21/2020

always like rural research. looking forward to learning more about this project. thanks for your efforts. and for sharing them with NAPCRG.

Isabelle Vedel

Thanks !

Isabelle Vedel

Thanks !

Judy Belle Brown

Given how much of Quebec is rural these findings a very important !! Thanks !!

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