A framework for modeling the consumption of health services by the rural elderly

This paper reports on an ongoing research program which seeks to assess the implications of population aging for housing, services and transportation in rural communities in the Province of Ontario. Specifically, the focus is on the modeling of health and social service consumption by elderly (over 65) persons. Following a review of the literature on service provision to senior citizens in Ontario, a modeling framework conceptualizing the process of service utilization at both the aggregate (user and nonuser characteristics) and individual (decision-making) levels is introduced. Data on use of community support services drawn from a survey of elderly residents in two communities in Grey County, Ontario (Meaford, population 4380 in 1986, and Markdale, population 1226 in 1986) are used to illustrate the general features of the modeling framework. Particular attention is paid to the ability of the modeling framework to yield insights into the origins of notable variations in service use rates between men and women. Overall, the results are taken to be supportive of the usefulness of the modeling framework as a template for guiding empirical analysis of service utilization patterns. At the same time the case study testifies to the complex and dynamic nature of service provision issues in rural communities. The challenge of providing services effectively to an elderly rural population located in scattered villages and small towns will continue to tax the imagination and resources of responsible agencies.