Trends in health service use among persons with Parkinson's disease by rurality: A population-based repeated cross-sectional study

被引：8

作者：

Maclagan, Laura C. ^{[1
]}

Marras, Connie ^{[1
,2
]}

Sewell, Isabella J. ^{[3
]}

Wu, C. Fangyun ^{[1
]}

Butt, Debra A. ^{[4
,5
]}

Tu, Karen ^{[5
,6
,7
,8
]}

Bronskill, Susan E. ^{[1
,3
,6
,9
]}

机构：

[1] ICES, Toronto, ON, Canada

[2] Toronto Western Hosp, Edmond J Safra Program Parkinson Dis, Toronto, ON, Canada

[3] Sunnybrook Hlth Sci Ctr, Sunnybrook Res Inst, Toronto, ON, Canada

[4] Scarborough Gen Hosp, Dept Family & Community Med, Scarborough Hlth Network, Toronto, ON, Canada

[5] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada

[6] Univ Toronto, Inst Hlth Policy, Dalla Lana Sch Publ Hlth, Management & Evaluat, Toronto, ON, Canada

[7] North York Gen Hosp, Toronto, ON, Canada

[8] Univ Hlth Network, Toronto Western Family Hlth Team, Toronto, ON, Canada

[9] Womens Coll Hosp, Womens Coll Res Inst, Toronto, ON, Canada

来源：

PLOS ONE | 2023年 / 18卷 / 05期

关键词：

TO-DOOR SURVEY; PREVALENCE; CARE; ONTARIO; HOSPITALIZATIONS; SYSTEMS; PD;

D O I：

10.1371/journal.pone.0285585

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

BackgroundThe global burden of Parkinson's disease (PD) has more than doubled over the past three decades, and this trend is expected to continue. Despite generally poorer access to health care services in rural areas, little previous work has examined health system use in persons with PD by rurality. We examined trends in the prevalence of PD and health service use among persons with PD by rurality in Ontario, Canada. MethodsWe conducted a repeated, cross-sectional analysis of persons with prevalent PD aged 40+ years on April 1(st) of each year from 2000 to 2018 using health administrative databases and calculated the age-sex standardized prevalence of PD. Prevalence of PD was also stratified by rurality and sex. Negative binomial models were used to calculate rate ratios with 95% confidence intervals comparing rates of health service use in rural compared to urban residents in 2018. ResultsThe age-sex standardized prevalence of PD in Ontario increased by 0.34% per year (p<0.0001) and was 459 per 100,000 in 2018 (n = 33,479), with a lower prevalence in rural compared to urban residents (401 vs. 467 per 100,000). Rates of hospitalizations and family physician visits declined over time in both men and women with PD in rural and urban areas, while rates of emergency department, neurologist, and other specialist visits increased. Adjusted rates of hospitalizations were similar between rural and urban residents (RR = 1.04, 95% CI [0.96, 1.12]), while rates of emergency department visits were higher among rural residents (RR = 1.35, 95% CI [1.27, 1.42]). Rural residents had lower rates of family physician (adjusted RR = 0.82, (95% CI [0.79, 0.84]) and neurologist visits (RR = 0.74, 95% CI [0.72, 0.77]). InterpretationLower rates of outpatient health service use among persons residing in rural regions, contrasting with higher rates of emergency department visits suggest inequities in access. Efforts to improve access to primary and specialist care for persons with PD in rural regions are needed.

引用

页数：13

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