title: Access to Specialist Care in Rural Saskatchewan: The Saskatchewan Rural Health Study.
abstract: The role of place has emerged as an important factor in determining people's health experiences. Rural populations experience an excess in mortality and morbidity compared to those in urban settings. One of the factors thought to contribute to this rural-urban health disparity is access to healthcare. The objective of this analysis was to examine access to specialized medical care services and several possible determinants of access to services in a distinctly rural population in Canada. In winter 2010, we conducted a baseline mail survey of 11,982 households located in rural Saskatchewan, Canada. We obtained 4620 completed household surveys. A key informant for each household responded to questions about access to medical specialists and the exact distance traveled to these services. Correlates of interest included the location of the residence within the province and within each household, socioeconomic status, household smoking status, median age of household residents, number of non-respiratory chronic conditions and number of current respiratory conditions. Analyses were conducted using log binomial regression for the outcome of interest. The overall response rate was 52%. Of households who required a visit to a medical specialist in the past 12 months, 23% reported having difficulty accessing specialist care. The magnitude of risk for encountering difficulty accessing medical specialist care services increased with the greatest distance categories. Accessing specialist care professionals by rural residents was particularly difficult for persons with current respiratory conditions.
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. cpk646@mail.usask.ca.
authors.forename: Chandima P
authors.initials: CP
authors.lastname: Karunanayake
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. donna.rennie@usask.ca.|College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. donna.rennie@usask.ca.
authors.forename: Donna C
authors.initials: DC
authors.lastname: Rennie
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. louise.hagel@usask.ca.
authors.forename: Louise
authors.initials: L
authors.lastname: Hagel
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. josh.lawson@usask.ca.|Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada. josh.lawson@usask.ca.
authors.forename: Joshua
authors.initials: J
authors.lastname: Lawson
authors.affiliation: Department of Community Health &#38; Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada. bonnie.janzen@usask.ca.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Janzen
authors.affiliation: Department of Public Health Sciences, Queens University, Kingston, ON K7L 3N6, Canada. will.pickett@queensu.ca.
authors.forename: William
authors.initials: W
authors.lastname: Pickett
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. james.dosman@usask.ca.
authors.forename: James A
authors.initials: JA
authors.lastname: Dosman
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada. bonnie.janzen@usask.ca.|Department of Community Health &#38; Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada. bonnie.janzen@usask.ca.
authors.forename: Punam
authors.initials: P
authors.lastname: Pahwa
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
authors.lastname: The Saskatchewan Rural Health Study Group
keywords: distance; rural; specialist care