The objective of this thesis was to determine whether the development of a regionalized health care system in Quebec has enabled this province to meet the health services needs of its citizens in the face of Federal cuts to health care. This was accomplished through the quantitative analysis of the relationship between the incidence of family physician use and self-assessed health status (a proxy for need for care) in Quebec. The data for this study came from the 1987 and 1992-93 Santé Quebec which is a weighted random sample of the citizens living in Quebec aged 15 years and over. Using Aday and Andersen's (1974) framework for the study of access to medical care, the relationship between physician utilization and need, predisposing and enabling characteristics of individuals were analyzed for both years of the survey. The results at the provincial level revealed that need was the most important determinant of use and further that those with higher levels of need had a greater probability of use. Yet, non-need variables were also important in determining use. Specifically, the importance of predisposing factors increased from 1987 to 1992-93. The data were also partitioned by need level and by health region (15 of the 18 health regions in Quebec were included in the Santé Quebec survey). These results showed that need level was important in influencing the associations between the enabling and predisposing variables and utilization. When the data were disaggregated to the regional level, a complex pattern of utilization behaviour appeared which was not apparent at the provincial level. The results of this analysis show that while regionalization has allowed the province of Quebec to better identify the health care needs of Quebec residents, variations in utilization still exist. It has also shown that while socio-economic barriers to use have diminished, the importance of socio-demographic characteristics have increased over time. There are three important conclusions which can be drawn from this analysis; 1) need is an important determinant of physician use, 2) temporal and spatial data analysis should be included in investigations of this type as they can reveal important variations which would otherwise be unnoticed, and 3) further research in this area should incorporate the use of both qualitative and quantitative analysis in order to better identify the individual processes involved in using physician services. / Thesis / Master of Arts (MA)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/23121 |
| Date | 06 1900 |
| Creators | Wilson, Kathleen |
| Contributors | Eyles, John, Geography |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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