Accessibility to long-term care: A comparison of Fredericton, New Brunswick, Canada and Clark County, Nevada

Schuyler Van Rensselaer Quick, University of Nevada, Las Vegas


There has been extensive debate in this country on the ability of the health care system to adequately distribute Long Term Care (LTC) to the elderly. Three perspectives have emerged to explain current problems in access to LTC by the elderly indigent: The Market Model Perspective, Weber's Bureaucratic Perspective, and the Neo-Marxist Perspective. This study will assess these three theories, by examining constraints to accessibility within two systems, Canada and the United States. The LTC delivery service systems of the Fredericton region of New Brunswick and Clark County, Nevada, were examined in the summer and fall of 1992, to ascertain impediments to access as identified by service providers; The research also analyzes the Fredericton region, before and after their enactment of the Single-Entry Point System for LTC. The research is composed of three components: (1) Historical Perspective, (2) Interviews with LTC providers and, (3) Content analysis. Of the three perspectives, the Neo-Marxist Perspective was found to best explain identifiable constraints among the two countries.