The 130th Annual Meeting of APHA

Abstract #44899

Audrey Laporte, PhD¹, Peter C. Coyte, PhD¹, and Ruth Croxford, MSc². (1) Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, McMurrich Bldg. 2nd Fl., 12 Queen's Park Cres. W., Toronto, ON M5S 1A8, Canada, 416-946-7386, audrey.laporte@utoronto.ca, (2) Institute for Clinical Evaluative Sciences/Home and Community Evaluation Research Centre, 2075 Bayview Ave. Room G106, Toronto, ON M4N 3M5, Canada

Over the last decade the setting for care provision and receipt has shifted from the hospital to the home in most industrialized countries. The implications of this shift in terms of access to health care services by the economically underprivileged have not been fully explored. The issue is of particular concern since in-home care is likely to place a much greater burden on family resources. This paper explores the relationship between access to in-home services (e.g. nursing, personal support etc.) and various characteristics of care recipients i.e. age, sex, indicators of socio-economic status, across Ontario’s 43 Community Care Access Centres (CCACs). The analysis is conducted in the context of a two-part model. Access is defined along two dimensions: propensity and intensity of utilization. Propensity refers to whether or not an individual uses in-home services and intensity describes the amount and range of services used by a care recipient that qualified for in-home care. The first stage of the analysis considers the propensity to use in-home services using a multinomial logit structure and the second stage employs an OLS regression to estimate intensity. The results identify areas in which barriers to in-home services, based on socio-economic status and other factors, exist and where health managers may target services more effectively.

Learning Objectives: At the conclusion of this session, the participant in this session will be able to

• Identify various dimensions of an individual's socio-economic status.
• Understand the application of two-part models in the context of health care decision-making.
• Apply the research approach to address questions related to the accessibility of health care services.

Keywords: Access, Economic Analysis

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.