Abstract
Objective
Youth have distinct health care needs that are not always met within a framework designed for children or adults. In Canada, little attention has been given to how youth utilize health care services and limited data are available. The aim of this study was to identify whether age, sex, socio-economic status (SES) and geographic location were significant mediators of youth health care utilization in Nova Scotia.
Methods
The NSYOUTHS database comprises health care utilization information for all youth aged 12 to 24 years, resident in Nova Scotia between 1997 and 2007. We calculated health care utilization rates by provider, stratified by sex, age, SES, urban/rural residence and year. Negative binomial regression was used to model the variation in health care utilization by sex, SES and urban/rural location.
Results
Health care utilization declined over time and varied by age. Females were more frequent users of services. Youth from lower SES areas had fewer family physician contacts but more outpatient, emergency and inpatient contacts compared to those from higher SES areas. Rural residents had fewer family physician and emergency contacts but more outpatient contacts than youth from urban areas. Ten percent of the youth were responsible for 32% of all health care contacts, whereas 11 % had no health care contacts.
Conclusion
Specific subgroups, including youth from rural areas and of lower SES, utilize health care services differently than other youth. The challenge is to provide health care that is responsive to the needs of this heterogeneous population. Meeting this challenge requires accurate information on youth health care utilization.
Key Words: Youth, health service utilization, socio-economic status, geography
Résumé
Objectif
En matière de soins de santé, les jeunes ont des besoins distincts qui ne sont pas toujours satisfaits dans un cadre conçu pour les enfants ou les adultes. Au Canada, on porte peu d’attention à la question de l’utilisation des services de santé par les jeunes, et les données disponibles à ce sujet sont limitées. Nous avons tenté de déterminer si l’âge, le sexe, le statut socioéconomique (SSE) et l’emplacement géographique sont des médiateurs significatifs de l’utilisation des services de santé par les jeunes en Nouvelle-Écosse.
Méthode
La base de données NSYOUTHS contient de l’information sur l’utilisation des soins de santé par tous les jeunes de 12 à 24 ans qui résidaient en Nouvelle-Écosse entre 1997 et 2007. Nous avons calculé les taux d’utilisation des soins de santé par fournisseur et avons stratifié les résultats selon le sexe, l’âge, le SSE, le lieu de résidence (urbain ou rural) et l’année. Par régression binomiale négative, nous avons modélisé les écarts dans l’utilisation des soins de santé selon le sexe, le SSE et le lieu de résidence (urbain ou rural).
Résultats
L’utilisation des soins de santé diminuait avec le temps et variait selon l’âge. Les jeunes femmes et les filles y avaient recours plus fréquemment que les jeunes hommes et les garçons. Les jeunes des régions de faible SSE avaient moins de contacts avec leurs médecins de famille, mais plus de contacts avec les soins ambulatoires, les urgences et les soins en établissement comparativement aux jeunes des régions de SSE élevé. Les jeunes en milieu rural avaient moins de contacts avec leurs médecins de famille et les urgences, mais plus de contacts avec les soins ambulatoires que les jeunes des zones urbaines. Dix p. cent des jeunes ont eu 33 % des contacts avec les soins de santé, tandis que 11 % n’ont eu aucun contact avec les soins de santé.
Conclusion
Certains sous-groupes, dont les jeunes des milieux ruraux et des régions de faible SSE, utilisent les services de santé différemment des autres jeunes. La difficulté est d’offrir des soins de santé adaptés aux besoins de cette population hétérogène. Il faut pour cela avoir de l’information exacte sur l’utilisation des services de santé par les jeunes.
Mots Clés: jeunes, utilisation des services de santé, statut socioéconomique, géographie
Footnotes
Source of Funding: Nova Scotia Health Research Foundation.
Conflict of Interest: None to declare.
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