Geographic variation in osteoarthritis prevalence in Alberta: A spatial analysis approach

Marshall, Deborah; Liu, Xiaoxiao; Shahid, Rizwan; Bertazzon, Stefania; Seidel, Judy; Patel, Alka; Nasr, Mina; Barber, Claire; McDonald, Terrence; Sharma, Rajrishi; Briggs, Tom; Faris, Peter; Waters, Nigel

doi:10.1016/j.apgeog.2019.01.004

Cited by 11 publications

(18 citation statements)

References 31 publications

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“…4,14 Detailed geographic analysis can be used to more precisely plan population needs. 15,16 Incentivizing subspecialty physicians to set up practice in rural/remote communities may be impractical given the need for a significant population base to sustain a viable practice. Telemedicine 17 and traveling clinics represent alternative strategies to deliver care to underserved, rural and/or remote populations.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing rheumatology residents’ decision on future practice location

et al. 2020

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Background: There are regional disparities in the distribution of Canadian rheumatologists. The objective of this study was to identify factors impacting rheumatology residents’ postgraduate practice decisions to inform Canadian Rheumatology Association workforce recommendations. Methods: An online survey was developed, and invitations were sent to all current Canadian rheumatology residents in 2019 (n = 67). Differences between subgroups of respondents were examined using the Pearson χ2 test. Results: A total of 34 of 67 residents completed the survey. Seventy-three percent of residents planned to practice in the same province as their rheumatology training. The majority of residents (80%) ranked proximity to friends and family as the most important factor in planning. Half of participants had exposure to alternative modes of care delivery (e.g. telehealth) during their rheumatology training with fifteen completing a community rheumatology elective (44%). Conclusions: The majority of rheumatology residents report plans to practice in the same province as they trained, and close to home. Gaps in training include limited exposure to community electives in smaller centers, and training in telehealth and travelling clinics for underserviced populations. Our findings highlight the need for strategies to increase exposure of rheumatology trainees to underserved areas to help address the maldistribution of rheumatologists.

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Section: Discussionmentioning

confidence: 99%

Factors influencing rheumatology residents’ decision on future practice location

et al. 2020

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“…Our data sources were five Alberta Health (AH) administrative databases: Alberta Health Care Insurance Plan population registry (AHCIP), Physician Claims, Discharge Abstract Database (DAD), and Ambulatory Care Classification System (ACCS) /National Ambulatory Care Reporting System (NACRS) [ 4 , 17 , 22 ]. The AHCIP population registry captures individual level data (age, sex, postal code, death, etc.)…”

Section: Methodsmentioning

confidence: 99%

“…A report of arthritis prevalence estimates suggested that arthritis prevalence, risk factors and management of arthritis across the US states varied substantially by geographic area [ 15 ]. Studies have examined the prevalence of arthritis in Canada at both provincial and regional level [ 8 , 9 ], [ 16 ], and the prevalence of OA at local level [ 17 ]. OA had a substantially higher prevalence rate in Rural Remote and Rural areas than the Metro and Urban areas [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have examined the prevalence of arthritis in Canada at both provincial and regional level [ 8 , 9 ], [ 16 ], and the prevalence of OA at local level [ 17 ]. OA had a substantially higher prevalence rate in Rural Remote and Rural areas than the Metro and Urban areas [ 17 ]. The Canadian Medical Association and Alberta Health Services (AHS) have a goal of achieving equitable access to care, with a focus on reducing health disparities for patients in rural and remote areas [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada

et al. 2020

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Background Knowledge of geospatial pattern in comorbidities prevalence is critical to an understanding of the local health needs among people with osteoarthritis (OA). It provides valuable information for targeting optimal OA treatment and management at the local level. However, there is, at present, limited evidence about the geospatial pattern of comorbidity prevalence in Alberta, Canada. Methods Five administrative health datasets were linked to identify OA cases and comorbidities using validated case definitions. We explored the geospatial pattern in comorbidity prevalence at two standard geographic areas levels defined by the Alberta Health Services: descriptive analysis at rural-urban continuum level; spatial analysis (global Moran’s I, hot spot analysis, cluster and outlier analysis) at the local geographic area (LGA) level. We compared area-level indicators in comorbidities hotspots to those in the rest of Alberta (non-hotspots). Results Among 359,638 OA cases in 2013, approximately 60% of people resided in Metro and Urban areas, compared to 2% in Rural Remote areas. All comorbidity groups exhibited statistically significant spatial autocorrelation (hypertension: Moran’s I index 0.24, z score 4.61). Comorbidity hotspots, except depression, were located primarily in Rural and Rural Remote areas. Depression was more prevalent in Metro (Edmonton-Abbottsfield: 194 cases per 1000 population, 95%CI 192–195) and Urban LGAs (Lethbridge-North: 169, 95%CI 168–171) compared to Rural areas (Fox Creek: 65, 95%CI 63–68). Comorbidities hotspots included a higher percentage of First Nations or Inuit people. People with OA living in hotspots had lower socioeconomic status and less access to care compared to non-hotspots. Conclusions The findings highlight notable rural-urban disparities in comorbidities prevalence among people with OA in Alberta, Canada. Our study provides valuable evidence for policy and decision makers to design programs that ensure patients with OA receive optimal health management tailored to their local needs and a reduction in current OA health disparities.

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“…Rural–urban disparities in the prevalence of osteoarthritis (OA) have been reported at national and provincial levels in Canada, demonstrating significantly higher rates of OA in rural and remote areas compared to urban areas [ 1 , 2 , 3 ]. The population health burden of OA is expected to increase and reach one in four Canadians by 2040 [ 4 , 5 ] due to an aging population and rising rates of obesity [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Rural–Urban Differences in Non-Local Primary Care Utilization among People with Osteoarthritis: The Role of Area-Level Factors

Liu

Seidel

McDonald

et al. 2022

IJERPH

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The utilization of non-local primary care physicians (PCP) is a key primary care indicator identified by Alberta Health to support evidence-based healthcare planning. This study aims to identify area-level factors that are significantly associated with non-local PCP utilization and to examine if these associations vary between rural and urban areas. We examined rural–urban differences in the associations between non-local PCP utilization and area-level factors using multivariate linear regression and geographically weighted regression (GWR) models. Global Moran’s I and Gi* hot spot analyses were applied to identify spatial autocorrelation and hot spots/cold spots of non-local PCP utilization. We observed significant rural–urban differences in the non-local PCP utilization. Both GWR and multivariate linear regression model identified two significant factors (median travel time and percentage of low-income families) with non-local PCP utilization in both rural and urban areas. Discontinuity of care was significantly associated with non-local PCP in the southwest, while the percentage of people having university degree was significant in the north of Alberta. This research will help identify gaps in the utilization of local primary care and provide evidence for health care planning by targeting policies at associated factors to reduce gaps in OA primary care provision.

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Geographic variation in osteoarthritis prevalence in Alberta: A spatial analysis approach

Cited by 11 publications

References 31 publications

Factors influencing rheumatology residents’ decision on future practice location

Factors influencing rheumatology residents’ decision on future practice location

Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada

Rural–Urban Differences in Non-Local Primary Care Utilization among People with Osteoarthritis: The Role of Area-Level Factors

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