Table 2. Rate Ratios of Health Service Use by Community-Dwelling Persons With Dementia, Persons With Parkinson Disease, and Older Adults Comparing the COVID-19 Pandemic Period With the Historical Period in Ontario, Canada.
| Health service/outcome | Rate ratios (95% CI) | Cumulative change in No. of outcomes, No.c | |
|---|---|---|---|
| At lowest rate in 2020a | At latest weekb | ||
| Dementia | |||
| Emergency department visits | 0.45 (0.41-0.48) | 0.98 (0.93-1.04) | −18 380 |
| Hospital | |||
| Admissions | 0.61 (0.55-0.67) | 0.94 (0.86-1.03) | −4342 |
| Discharges | 0.58 (0.53-0.64) | 1.00 (0.93-1.09) | −3755 |
| Discharges with a delay | 0.46 (0.38-0.56) | 1.11 (0.95-1.30) | −216 |
| Visits | |||
| Total physician | 0.70 (0.68-0.71) | 1.07 (1.05-1.09) | −33 848 |
| Family physician | 0.78 (0.76-0.80) | 1.10 (1.08-1.12) | 17 043 |
| Total specialist | 0.56 (0.54-0.57) | 1.03 (1.00-1.05) | −50 892 |
| Neurologist | 0.54 (0.48-0.62) | 1.31 (1.18-1.45) | −1064 |
| Geriatrician/psychiatrist | 0.60 (0.56-0.65) | 1.11 (1.05-1.18) | −1044 |
| Other specialistd | 0.55 (0.53-0.57) | 0.99 (0.96-1.02) | −48 785 |
| Home care | 0.85 (0.84-0.85) | 1.01 (1.00-1.01) | −721 240 |
| Nursing home admissions | 0.10 (0.07-0.15) | 0.76 (0.64-0.91) | −3954 |
| Mortality | 1.40 (1.16-1.68)a | 1.04 (0.86-1.25) | 1092 |
| Parkinson disease | |||
| Emergency department visits | 0.40 (0.34-0.48) | 0.96 (0.84-1.10) | −2887 |
| Hospital | |||
| Admissions | 0.60 (0.47-0.76) | 1.02 (0.83-1.26) | −535 |
| Discharges | 0.66 (0.51-0.84) | 1.23 (1.00-1.51) | −542 |
| Discharges with a delay | 0.36 (0.20-0.64) | 1.47 (0.95-2.28) | −116 |
| Visits | |||
| Total physician | 0.66 (0.64-0.69) | 1.10 (1.06-1.13) | −7283 |
| Family physician | 0.75 (0.72-0.79) | 1.08 (1.04-1.13) | 3377 |
| Total specialist | 0.55 (0.52-0.59) | 1.12 (1.07-1.17) | −10 661 |
| Neurologist | 0.52 (0.46-0.58) | 1.52 (1.39-1.67) | 215 |
| Geriatrician/psychiatrist | 0.63 (0.53-0.75) | 1.21 (1.04-1.40) | 331 |
| Other specialistd | 0.55 (0.52-0.60) | 0.98 (0.92-1.04) | −11 207 |
| Home care | 0.80 (0.79-0.81) | 1.00 (0.99-1.01) | −118 851 |
| Nursing home admissions | 0.03 (0.00-0.21) | 1.14 (0.67-1.96) | −399 |
| Mortality | 1.61 (1.00-2.60)a | 1.44 (0.88-2.36) | 150 |
| Older adults e | |||
| Emergency department visits | 0.45 (0.44-0.47) | 0.91 (0.89-0.93) | −108 900 |
| Hospital | |||
| Admissions | 0.54 (0.52-0.56) | 0.94 (0.90-0.97) | −31 075 |
| Discharges | 0.54 (0.52-0.56) | 0.96 (0.92-0.99) | −30 034 |
| Discharges with a delay | 0.61 (0.53-0.71) | 0.87 (0.77-0.98) | −2111 |
| Visits | |||
| Total physician | 0.59 (0.59-0.59) | 0.99 (0.98-0.99) | −1 108 852 |
| Family physician | 0.63 (0.62-0.63) | 1.00 (1.00-1.01) | −424 470 |
| Total specialist | 0.54 (0.53-0.54) | 0.96 (0.96-0.97) | −684 390 |
| Neurologist | 0.61 (0.57-0.65) | 1.15 (1.09-1.21) | −4679 |
| Geriatrician/psychiatrist | 0.72 (0.69-0.75) | 1.10 (1.06-1.14) | 13 717 |
| Other specialistd | 0.53 (0.52-0.53) | 0.96 (0.95-0.96) | −693 430 |
| Home care | 0.87 (0.86-0.87) | 1.01 (1.00-1.01) | 68 776 |
| Nursing home admissions | 0.11 (0.06-0.18) | 0.55 (0.41-0.72) | −2001 |
| Mortality | 1.12 (1.02-1.23)a | 1.10 (1.00-1.22) | 1481 |
a
For all-cause mortality, the pandemic period rates increased (rather than decreased); therefore, rate ratios for the highest week are presented.
b
The latest weekly rate is as of September 20, 2020, and September 22, 2019, for all services.
c
The cumulative change in the number of outcomes was calculated comparing the number of events within the pandemic period (March 1 to September 20, 2020) and historical period (March 3 and September 22, 2019). Negative values indicate a decreased number of events in the 2020 COVID-19 pandemic period.
d
Other specialist includes specialists other than neurologists, geriatricians, and psychiatrists.
e
Older adults include persons aged 65 years and older without a diagnosis of neurodegenerative diseases.