Perceived Barriers to Accessing Specialized Medical Care in Rural Communities of Ontario: A Pilot Study

Sapru, Iman; Cassidy, Kelsey; Sibbald, Shannon L.

doi:10.5206/wurjhns.2014-15.4

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…One such care process to consider is patient referral between primary care providers, movement disorder specialists, and neurosurgeons, or lack thereof. 23 Regional differences in DBS surgery were not observed in our subgroup analyses of patients 67+ years of age or after accounting for PD medication use within the subgroup. These findings may be attributed to differences in patterns of health care utilization among older adults with PD compared to other PD populations.…”

Section: Discussionmentioning

confidence: 61%

Disparities in Deep Brain Stimulation Use for Parkinson’s Disease in Ontario, Canada

Crispo

Lam²,

Le³

et al. 2020

Can. J. Neurol. Sci.

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Objective: To examine whether sociodemographic characteristics and health care utilization are associated with receiving deep brain stimulation (DBS) surgery for Parkinson’s disease (PD) in Ontario, Canada. Methods: Using health administrative data, we identified a cohort of individuals aged 40 years or older diagnosed with incident PD between 1995 and 2009. A case-control study was used to examine whether select factors were associated with DBS for PD. Patients were classified as cases if they underwent DBS surgery at any point 1-year after cohort entry until December 31, 2016. Conditional logistic regression modeling was used to estimate the adjusted odds of DBS surgery for sociodemographic and health care utilization indicators. Results: A total of 46,237 individuals with PD were identified, with 543 (1.2%) receiving DBS surgery. Individuals residing in northern Ontario were more likely than southern patients to receive DBS surgery [adjusted odds ratio (AOR) = 2.23, 95% confidence interval (CI) = 1.15–4.34]; however, regional variations were not observed after accounting for medication use among older adults (AOR = 1.04, 95% CI = 0.26–4.21). Patients living in neighborhoods with the highest concentration of visible minorities were less likely to receive DBS surgery compared to patients living in predominantly white neighborhoods (AOR = 0.27, 95% CI = 0.16–0.46). Regular neurologist care and use of multiple PD medications were positively associated with DBS surgery. Conclusions: Variations in use of DBS may reflect differences in access to care, specialist referral pathways, health-seeking behavior, or need for DBS. Future studies are needed to understand drivers of potential disparities in DBS use.

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Section: Discussionmentioning

confidence: 61%

Disparities in Deep Brain Stimulation Use for Parkinson’s Disease in Ontario, Canada

Crispo

Lam²,

Le³

et al. 2020

Can. J. Neurol. Sci.

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Evaluating quality of care for patients with rotator cuff disorders

Eubank

Lafave

Wiley

et al. 2018

BMC Health Serv Res

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BackgroundMeasuring quality in healthcare is vital in evaluating patient outcomes and system performance. The availability of reliable and valid information about the quality of care for patients presenting with rotator cuff disorders (RCD) in Alberta, Canada is scarce. The objective of this study is to measure quality of care for patients with RCD in order to identify areas of improvement.MethodsThis study employs descriptive survey research design. Between March 2015 and November 2016, a convenience sample of patients presenting with chronic, full-thickness rotator cuff tears to two sport medicine centres in Calgary and Edmonton, Alberta completed two questionnaires: the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) and the Rotator Cuff Quality-of-Life Index (RC-QOL). Data collected using both questionnaires were used to make judgments about quality of care. Quality of care was evaluated using six dimensions of quality defined by the Alberta Quality Matrix for Health: accessibility, acceptability, efficiency, effectiveness, appropriateness, and safety. Data was also used to compare current patient clinical pathways to ideal clinical pathway algorithms and used to make judgments about the appropriateness and safety of healthcare practices.ResultsOne hundred seventy-one patients participated in the study. The longest mean waiting times for medical services in Alberta were for magnetic resonance imaging (MRI) received in the public sector (103 days) and consultation by orthopaedic surgeon (172 days). Patient satisfaction with respect to quality of care was lowest for emergency room physician and highest for orthopaedic surgeon visits. Patients were treated by a mean of 2.5 physicians (SD: 0.77, range: 2–7). The total aggregate average cost per patient was $4541.19. The mean RC-QOL score for all patients was 42 (SD: 22). Only 54 patients (64%) requiring surgery were able to consult with a surgeon within benchmark timeframes. A comparison of current to ideal clinical pathway algorithms found that 38 patients (22%) experienced indirect clinical pathways, whereby care was fragmented and patients received care from multiple and often, redundant healthcare professionals.ConclusionThere is a discrepancy between current and ideal clinical pathways whereby some patients are experiencing quality of care that is inefficient, disjointed, and less than ideal.

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The experiences of rural British Columbians accessing surgical and obstetrical care

Jazdarehee¹,

Parajulee²,

Kornelsen³

2021

Patient Experience Journal

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Perceived Barriers to Accessing Specialized Medical Care in Rural Communities of Ontario: A Pilot Study

Cited by 3 publications

References 17 publications

Disparities in Deep Brain Stimulation Use for Parkinson’s Disease in Ontario, Canada

Disparities in Deep Brain Stimulation Use for Parkinson’s Disease in Ontario, Canada

Evaluating quality of care for patients with rotator cuff disorders

The experiences of rural British Columbians accessing surgical and obstetrical care

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