Concept: Health Regions in Manitoba

Introduction

The term "health region" generally describes geographical areas defined by specific health-related boundaries that allow for area-level analysis and comparison. Over time, different health regions have been defined and used in MCHP research.

This concept briefly describes the various "health region" definitions used in MCHP research over time and provides links to more detailed information describing each method. Links to other methods of regional analysis used in MCHP research are also provided.

Health Regions in Manitoba

There are three major definitions of "health regions" used in MCHP research over time.

1. Administrative Health Regions

Prior to the formation of the Regional Health Authorities (RHAs), Manitoba was divided first into 7 administrative regions (from 1970 to March, 1989) and then into 10 regions (from April 1989 to ~1997), with Winnipeg partitioned into 3 zones. The regions were divided as follows:

7 Health Regions (1970 - 1989/03)


• Central
• Eastman
• Interlake
• NOR-MAN
• Parkland
• Westman
• Winnipeg

10 Health Regions (1989/04 - ~1997)


• Central
• Eastman
• Interlake
• NOR-MAN
• Thompson
• Parkland
• Westman
• Winnipeg (1-3)

In order to divide research data into 7 or 10 regions, a REGION variable needs to be created using the variable municipal code (MUNCODE). In most MCHP datasets, regions have also been defined for individuals and hospitals.

Creating 7 or 10 regions with the municipal code can be done for both Hospital Discharge Abstracts and Medical Services/Physician Claims data, but Treaty Status Indians may be classified inappropriately using municipal code only (see CAUTION below).

NOTE:
• Because of changes in municipal codes and their associated regions, 10 and 7 region formats are not interchangeable. There are a number of municipal codes that have been created, or removed between each format. A number of municipal codes have moved between Westman and Parkland, Winnipeg was separated into 3 areas, and many municipal codes have changed.
• The 10 region format will not work prior to 1989 due to municipal codes associated with Winnipeg and unorganized territories. The unorganized territories in northern Manitoba are classified as the NOR-MAN region in the 7 region format based on a majority rule in the population.
• The 7 region format will not work on data after 1989.

CAUTION:


• Municipal code is generally used to assign REGION, except for Treaty Status Indians whose records are generally assigned using postal codes. This is done because all Status Indians are assigned a municipal code that corresponds to their associated band, but that may not reflect where they actually live.

Please see the SAS code and formats section below internal access only for example SAS code related to working with the 7 or 10 administrative health regions.

2. Physician Service Areas (PSA)

This method of defining health regions in Manitoba defines geographic areas based on where general practitioners (GPs) are providing services and where residents are receiving services. Including Winnipeg, there are 54 PSAs in Manitoba.

This method of defining health regions was used in the following MCHP research: Wall RW (1997), Black et al. (1999), and Stewart et al. (2000).

Please read the following concepts for more information on PSAs:


• Physician Service Areas (PSAs); and
  
• Physician Service Areas (PSAs) That Fit Inside the Regional Health Authorities (RHAs).

3. Regional Health Authorities (RHA)

In 1997, Manitoba created a structure called Regional Health Authorities that are responsible for the delivery and administration of health services in a specific geographical area. RHAs are further sub-divided into RHA Districts and more recently (in 2012) into RHA Zones.

This method of defining health regions has been used in several MCHP research projects, including the three RHA Atlas deliverables: Martens et al. (2003), Fransoo et al. (2009), and Fransoo et al. (2013).

Please read the following concepts for more information on RHAs:


• Regional Health Authorities (RHA) in Manitoba; and
  
• Regional Health Authorities (RHA) Districts and Zones in Manitoba;

Other Methods of Regional Analysis

For additional information on methods of regional analysis used at MCHP, please read the following concepts:


• Small Areas in Manitoba; and
  
• Small Areas Analysis