Abstract
BackgroundAlthough literature has associated geodemographic factors with healthcare service utilization, little is known about how these factors — such as population size, age profile, service accessibility, and educational profile — interact to influence service utilization. This study fills this gap in the literature by examining both the direct and the moderating effects of geodemographic profiles on the utilization of cardiac surgery services.MethodsWe aggregated secondary data obtained from Statistics Canada and Cardiac Care Network of Ontario to derive the geodemographic profiles of Ontario and the corresponding cardiac surgery service utilization in the years between 2004 and 2007. We conducted a two-step test using Partial Least Squares-based structural equation modeling to investigate the relationships between geodemographic profiles and healthcare service utilization.ResultsPopulation size and age profile have direct positive effects on service utilization (β=0.737, p<0.01; β=0.284, p<0.01, respectively), whereas service accessibility is negatively associated with service utilization (β=−0.210, p<0.01). Service accessibility decreases the effect of population size on service utilization (β=−0.606, p<0.01), and educational profile weakens the effects of population size and age profile on service utilization (β=−0.595, p<0.01; β=−0.286, p<0.01, respectively).ConclusionsIn this study, we found that (1) service accessibility has a moderating effect on the relationship between population size and service utilization, and (2) educational profile has moderating effects on both the relationship between population size and service utilization, and the relationship between age profile and service utilization. Our findings suggest that reducing regional disparities in healthcare service utilization should take into account the interaction of geodemographic factors such as service accessibility and education. In addition, the allocation of resources for a particular healthcare service in one area should consider the geographic distribution of the same services in neighboring areas, as patients may be willing to utilize these services in areas not far from where they reside.
Highlights
Literature has associated geodemographic factors with healthcare service utilization, little is known about how these factors — such as population size, age profile, service accessibility, and educational profile — interact to influence service utilization
In support of H4.2 and H4.3, our results reveal that educational profile weakens the effects of population size and age profile on service utilization, with the path coefficients being β = −0.595 (t = 7.592, p < 0.01) and β = −0.286 (t = 4.987, p < 0.01), respectively
As Local Health Integration Networks (LHINs) are sub-provincial administrative units responsible for planning and funding healthcare services for their corresponding geographic areas in Ontario [13], our study uncovers interesting relationships between LHINs’ geodemographic factors and healthcare service utilization, and provides valuable knowledge for LHIN administrators to consider in their planning and/or managing of healthcare service resources
Summary
Literature has associated geodemographic factors with healthcare service utilization, little is known about how these factors — such as population size, age profile, service accessibility, and educational profile — interact to influence service utilization This study fills this gap in the literature by examining both the direct and the moderating effects of geodemographic profiles on the utilization of cardiac surgery services. If one area has more healthcare service providers, the burden of population growth and aging on patient arrivals for a specific hospital in that area may be alleviated, as patients residing there have more choices and will be more likely to be distributed among multiple hospitals This suggests that geographic accessibility to services (referred to hereafter as service accessibility) [4] may have potential moderating effects on the relationships between population size/age profile and service utilization. This indicates that educational profile may have a potential moderating effect on the relationship between population size and healthcare service utilization
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