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Parkinsonism in Ontario: physician utilization

Guttman M, Slaughter PM, Theriault ME, DeBoer DP, Naylor CD. Can J Neurol Sci. 2002; 29(3):221-6.

Background — Patients with Parkinsonism have a progressive disorder requiring substantial expertise to manage effectively.

Methods — Over a six-year period we evaluated physician utilization and related costs for a large, unselected cohort of 15,304 Parkinsonian patients from the general population, comparing them to 30,608 age- and sex-matched controls within a universal health care system in Ontario, Canada.

Results — On average, 45% of Parkinsonian patients saw neurologists annually. The cumulative rate of at least one neurological consultation was only 59.5% over the six years. Patients aged < 65 had a much greater likelihood of consulting a neurologist (73.3%) compared to those > or = 65 (37.2%). Most Parkinsonian patients (97.2%), regardless of age, saw family physicians/general practitioners each year; 50.4% saw internal medicine consultants.

Conclusions — Parkinsonian patients had increased likelihood of utilizing neurologists, primary care physicians and internists compared to controls; related costs of physicians' services were higher. Further research is necessary to evaluate differences in outcomes and costs between neurologists and other physician service providers.

Keywords: Neurological disorders Health care utilization Health care costs