Grant: Operating Grant

Rural health care in Canada is characterised by frequent physician turnover and relatively large distances between providers. There is a high rate of international medical graduate staffing, and evidence that rural regions are medically underserved. These problems are compounded by the fact that rural Canadians are less healthy than their urban counterparts, which may be due to differences in socio-economic status, educational attainment and a higher prevalence of unhealthy behaviours among rural residents. However, these do not account for all the health differences, and utilisation, continuity of care and accessibility are other key factors. This research investigates the determinants of health care utilisation in rural areas using rich, administrative data from the province of Manitoba. The determinants of utilisation are not well-documented, with most studies reporting correlations rather than causes. The results of this study will contribute significantly to fill this gap, and complement previous research focusing on improving recruitment and retention of physicians in rural Manitoba to develop a comprehensive model of rural healthcare organisation. Given what is known about why physicians do not stay in rural jobs, changes to rural healthcare are inevitable and need to be made accounting for both the supply and demand sides. The overall policy goal is to develop a model for a sustainable, better-quality rural healthcare system that simultaneously incorporates working conditions that improve recruitment and retention of physicians in rural areas.