Abstract
An adult health survey was undertaken on the island portion of the Province of Newfoundland as part of the Newfoundland Panel on Health and Medical Care. This study aims to develop models of medical care utilization over a seven-year period, before and after a major restructuring of the provincial health care system. A health survey on a large sample (11,789 individuals) permits both descriptive and explanatory analysis at the regional level.
The results of the survey are presented first in a descriptive format, as they were included in reports for policy makers and managers, using administrative aggregations. To study regional differences, descriptive and multivariate analyses were done on an aggregation by an urban dimension, which divides the island into three areas. As expected, there were major differences across regions, and complex interactions on selected variables. The usefulness of health surveys for planning and evaluation of health reform is discussed.
Résumé
Un sondage sur la santé adulte a été entrepris dans la région insulaire de la province de Terre-Neuve et du Labrador, dans le cadre de la Table ronde terre-neuvienne sur la santé et les soins médicaux. Cette étude vise à élaborer des modèles d’utilisation des soins médicaux sur une période de sept ans, avant et après une restructuration importante du système provincial de la santé. Un sondage sur la santé auprès d’un grand échantillon (11 789 personnes) permet une analyse descriptive et explicative au niveau régional.
Les résultats du sondage se présentent d’abord sous un format descriptif, tels qu’ils étaient inclus dans les rapports destinés aux concepteurs et aux gérants de politiques, en se servant des agrégations administratives. Afin d’étudier les différences régionales, des analyses descriptives et à plusieurs variables ont été entreprises à partir d’une agrégation basée sur les villes, ce qui répartit l’île en trois régions. Comme on s’y attendait, des différences importantes, et des interactions complexes entre des variables choisis sont apparues. L’utilité des sondages sur la santé pour planifier et évaluer les réformes en santé est examinée.
Footnotes
Funded by grant No. 6601-1200-302, National Health Research and Development Program, Health Canada.
References
- 1.Kessler II, Levin M Eds. The Community as an Epidemiological Laboratory. Baltimore, MD: The Johns Hopkins Press; 1970. [Google Scholar]
- 2.Rosen G. The Evolution of Social Medicine. Chapter 2 In: Freeman HE, et al. Handbook of Medical Sociology. 1st edition. Englewood Cliffs, CA: Prentice-Hall; 1963. [Google Scholar]
- 3.Hollingshead AB, Redlich FC. Social Class & Mental Illness. New York, NY: John Wiley & Sons, Inc.; 1958. [Google Scholar]
- 4.Suchman EA. Sociology and the Field of Public Health. New York, NY: Russell Sage Foundation; 1963. [Google Scholar]
- 5.Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly. 1973;51:95–124. doi: 10.2307/3349613. [DOI] [PubMed] [Google Scholar]
- 6.Amick BC, Levine S, Tarlov AR, Walsh DC. Society and Health. New York, NY: Oxford University Press; 1995. [Google Scholar]
- 7.Blane D, Brunner E, Wilkinson R Eds. Health and Social Organization. London and New York: Routledge; 1996. [Google Scholar]
- 8.Advisory Committee on Population Health. Strategies for Population Health: Investing in the Health of Canadians. Ottawa: Minister of Supply and Services; 1994. [Google Scholar]
- 9.Evans RG, Barer ML, Marmor T Eds. Why are Some People Healthy and Others Not? New York, NY: Aldine de Gruyter; 1994. [Google Scholar]
- 10.Canada Health Survey. The Health of Canadians. Ottawa: Health and Welfare and Statistics Canada; 1981. [Google Scholar]
- 11.Emond A. Tome 1, Rapport de l’enquête Santé Québec. Gouvernement du Québec. 1988. Et La Santé, Ça Va? [Google Scholar]
- 12.Highlights from Wave I of the National Survey of Personal Health Practices and Consequences. 1979.
- 13.Segovia J, Edwards AC, Bartlett RF. Newfoundland Panel on Health and Medical Care; Adult Health Survey 1995 — Methodology and Descriptive Results. St. John’s: Health and Medical Care Research Group, Division of Community Medicine, Memorial University of Newfoundland; 1996. [Google Scholar]
- 14.Health and Medical Care Research Group -www.med.mun.ca/hmc; web site contains general information as well as the full text of three reports, including survey questionnaire.
- 15.Aday LA. Designing and Conducting Health Surveys. San Francisco, CA: Jossey-Bass Publishers; 1989. [Google Scholar]
- 16.Segovia J, Edwards AC, Bartlett RF. Socio-economic Status and Health–new evidence using a community laboratory approach (poster); 1997. [Google Scholar]
- 17.Bishop YMM, Feinberg SE, Holland PW. Discrete Multivariate Analysis: Theory and Practice. Cambridge, MA: MIT Press; 1975. [Google Scholar]