Parkinsonism in Ontario: physician utilization.
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.
Division of Neurology, Department of Medicine, University of Toronto, OntarioCanada.
M
M
Guttman
P M
PM
Slaughter
M E
ME
Theriault
D P
DP
DeBoer
C D
CD
Naylor
D016022:Case-Control Studies; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data; D017048:Health Care Costs; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D016013:Likelihood Functions; D009462:Neurology / Q000706:statistics & numerical data; D009819:Office Visits / Q000706:statistics & numerical data*; D009864:Ontario; D010300:Parkinson Disease / Q000191:economics / Q000628:therapy*; D010820:Physicians / Q000145:classification / Q000191:economics / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019472:Universal Health Insurance; D014600:Utilization Review