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.
Guttman
M
M
Division of Neurology, Department of Medicine, University of Toronto, OntarioCanada.
Slaughter
P M
PM
Theriault
M E
ME
DeBoer
D P
DP
Naylor
C D
CD
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