Health service utilization in immigrants with multiple sclerosis

Area of Science:

• Neurology
• Health Services Research
• Epidemiology

Background:

• Access to specialized neurological care impacts multiple sclerosis (MS) patient outcomes.
• Sociodemographic factors, including immigration status, can influence healthcare access for MS patients.

Purpose of the Study:

• To compare healthcare service utilization among immigrants and long-term residents in Ontario, Canada, around the time of MS diagnosis.
• Analyze differences in hospitalizations, emergency department visits, and outpatient neurology visits between immigrant and non-immigrant MS populations.

Main Methods:

• Utilized health administrative data from Ontario, Canada, to identify incident MS cases (2003-2014).
• Compared rates of hospitalizations, ED visits, and outpatient neurology visits using negative binomial regression.
• Adjusted for demographic and clinical factors including age, sex, socioeconomic status, and comorbidity burden.

Main Results:

• Immigrants (8.2%) showed similar hospitalization rates pre-diagnosis but fewer outpatient neurology visits.
• During the MS diagnosis year, immigrants had higher hospitalization rates and increased outpatient neurology use.
• Post-diagnosis, immigrants continued to use more outpatient neurology services but had fewer hospitalizations.

Conclusions:

• Findings suggest generally reassuring healthcare access for immigrants with MS in Ontario's public system.
• Immigrants' higher hospitalization rates during diagnosis year, despite increased outpatient neurology use, warrant further investigation.
• Potential factors for disparities include disease severity or social support deficits among immigrant populations.