Utilization of Neurology and Allied Health Services by People with Parkinson's Disease in Israel: A Retrospective Observational Study

Background: Sustainable utilization of neurology and allied health professions' services is pivotal for effective management of Parkinson disease (PD) and is correlated with positive health-related outcomes. Objectives: (1) To describe the utilization of neurology and allied health services by people with PD (PwP); (2) to explore the associations between demographic and structural variables and utilization; and (3) to test associations between utilization and unplanned hospitalizations. Methods: A retrospective observational cohort study of 1761 PwP in the years 2014-2019 was conducted. Utilization of neurology and allied health services was mapped. Regression models were examined to test associations between demographic and structural variables, utilization of neurology and physical therapy (PT), and unplanned hospitalizations. Results: Approximately 50% of the study population utilized neurology services. Utilization rate of allied health services ranged between 0% and 19%. The likelihood of utilizing neurology services increased for people with extended health insurance and people with more years since diagnosis and decreased for women and for people living at a great distance from a neurology service. The likelihood of utilizing PT increased for Jews and people with extended health insurance and decreased for people with more years since diagnosis and for people living at a great distance from a PT service. Among patients with fewer years since diagnosis (<5 years), those who utilized PT had a higher likelihood of unplanned hospitalization. Conclusions: Neurology and allied health services are underutilized by PwP, particularly by minorities and women. Policymakers should take proactive steps to increase utilization. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A496).