Objective: To identify spatial patterns of healthcare utilization among people with Parkinson’s disease (PwP) and examine factors associated with individuals’ observed access-to-care in Ontario.

Background: Parkinson’s disease is a progressive, neurodegenerative disorder affecting approximately 40,000 people in Ontario. With an aging population, its prevalence is expected to rise, as is the demand for care.  Improving our understanding of access-to-care is critical for the development of a system that more equitably contributes to improving quality-of-life for PwP and their caregivers, and is more resource effective.

Method: We employed a retrospective, population-based study design involving administrative health data. Parkinson’s disease cases (N=35,482) were identified using a previously validated case definition. Analysis involved: descriptive spatial analysis using comparative morbidity figures (CMFs) of disease prevalence and health service utilization by geographical area (n=76); and negative binomial regression modelling at the individual level to examine the association between Parkinson healthcare utilization and spatial access, while adjusting for other confounders (e.g. marginalization indices, comorbidities and demographic characteristics)

Results: We found marked spatial variability in prevalence and service use in Ontario. Prevalence was significantly higher (CMF >1.20; p<0.05) in urban areas as compared to the provincial average. For services use, neurology visits were significantly higher in urban areas (CMF>1.20; p<0.05), Family Physician visits were significantly higher (CMF >1.20; p<0.05) in rural areas. Factors associated with increased PD-related physician visits to any specialties include better spatial access, lower material deprivation, a lower comorbidity score, being male and being younger. Effects varied by physician specialty type.

Conclusion: These results contribute to our understanding of access-to-care barriers and the identification of geographic areas of both low and high accessibility.  Findings will contribute to the development of policy options and patient care models that will meet the needs of diverse populations of PwP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patterns-and-determinants-of-healthcare-utilization-among-people-with-parkinsons-disease-a-population-based-analysis-in-ontario-canada/