Objective: to map utilization of neurology and rehabilitation services by people with Parkinson’s disease (PD), and to identify associations between utilization and demographics.

Background: People with PD cope with the symptoms of serious illness for many years. To alleviate the burden and improve health, they are advised to use the services of neurology and rehabilitation professionals. However, data on the actual use of neurology and rehabilitation services for individuals with PD are lacking.

Method: A retrospective cohort study of 2,433 individuals with PD in a single district (72.61 ± 12.6 years, 52.9% male, 86.3% Jewish) was conducted using electronic medical records from a Health Maintenance Organization. The primary outcome variable was yearly utilization of neurology and rehabilitation services for 2014-2019. Demographic characteristics (age [i.e. <80 or ≥80], sex, ethnicity, socioeconomic and peripherality of residence) were analyzed for potential associations with service utilization. Outcome variables were operationalized as “no” if a service was not utilized and “yes” if one or more visits were made. Chi-square analysis was used to test associations between utilization in 2019 and demographic characteristics.

Results: Yearly utilization rates of neurological services ranged from 19.7% to 25% [Figure 1], while utilization rates of physical therapy, occupational therapy, and speech therapy services ranged from 13.9% to 14.9% [Figure 2], 2.8% to 11.2% [Figure 3], and 0% to 3.4%, respectively. Socioeconomic status and peripherality index were associated with neurology utilization (χ²=19.1, p<0.03; χ²=8.3, p<0.04); ethnicity and socioeconomic status were associated with physical therapy utilization (χ²=28.4, p<0.001; χ²=44, p<0.001); and ethnicity, age, socioeconomic and peripherality indices with occupational therapy utilization (χ²=5.4, p=0.02; χ²=15.9, p<0.001; χ²=25.9, p=0.002; χ²=11.7, p<0.009). Speech therapy utilization was associated with age (χ²=13.1, p<0.01).

Conclusion: Despite higher utilization of neurology services compared to rehabilitation services, both services are underutilized. The identification of demographic characteristics as potential barriers to service utilization highlights the need for policy makers to develop targeted outreach strategies to promote the use of these critical services by people with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/underutilization-of-neurology-and-rehabilitation-services-among-people-with-parkinsons-disease/