Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, Canada
Lau J, Scott MM, Everett K, Gomes T, Tanuseputro P, Jennings S, Bagnarol R, Zimmermann C, Isenberg SR. CMAJ. 2024;
Purpose — Some ethnic groups have more negative contacts with health services for first-episode psychosis, likely arising from a complex interaction between ethnicity, socio-economic factors, and immigration status. Using population-based health administrative data, we sought to examine the effects of ethnic group and migrant status on patterns of health service use preceding a first diagnosis of schizophrenia or schizoaffective disorder among people aged 14–35 over a 10-year period.
Methods — We compared access to care and intensity of service use for first-generation ethnic minority groups to the general population of Ontario. To control for migrant status, we restricted the sample to first-generation migrants and compared service use indicators for ethnic minority groups to the European migrant group.
Results — Our cohort included 18,080 people with a first diagnosis of schizophrenia or schizoaffective disorder, of whom 14.4% (n = 2607) were the first-generation migrants. Our findings suggest that the magnitude of ethnic differences in health service use is reduced and no longer statistically significant when the sample is restricted to first-generation migrants. Of exception, nearly, all migrant groups have lower intensity of primary care use, and Caribbean migrants are consistently less likely to use psychiatric services.
Conclusions — We observed fewer ethnic differences in health service use preceding the first diagnosis of psychosis when patterns are compared among first-generation migrants, rather than to the general population, suggesting that the choice of reference group influences ethnic patterning of health service use. We need a comprehensive understanding of the mechanisms behind observed differences for minority groups to adequately address disparities in access to care.
Anderson KK, McKenzie KJ, Kurdyak P. Soc Psychiatry Psychiatr Epidemiol. 2017; 52(8):949-61. Epub 2017 Jun 10.
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