Parkinson’s disease (PD) is a common chronic neurodegenerative condition. As a result of the COVID-19 pandemic, healthcare provision faced challenges worldwide. We aimed to explore how the COVID-19 pandemic changed healthcare experiences for people living with Parkinson’s disease (PwP) in Canada.

We conducted a national cross-sectional online survey about healthcare access for PwP in 2020. Participants (n = 298) were recruited through Parkinson Canada, the national patient association and its provincial partners, that advertised the study in a monthly newsletter. We used descriptive statistics and multivariate regression modelling to test associations of interest. A P < 0.05 was deemed statistically significant.

During the COVID-19 pandemic, PwP reported greater difficulty obtaining PD-related healthcare services and lesser satisfaction with healthcare provision compared to pre-pandemic experiences. Dissatisfaction with care was associated with the presence of barriers to access services, a lack of confidence in accessing services remotely, pre-pandemic care dissatisfaction, and difficulty in obtaining care during the COVID-19 pandemic. Unmet care needs were associated with a lack of confidence in accessing services remotely, dissatisfaction with pre-pandemic care, difficulty obtaining pre-pandemic care, and communication challenges.

Our results suggest that healthcare experiences for PwP significantly changed during the COVID-19 pandemic, with challenges in access to virtual care. Poorer pre-pandemic care experiences were amplified during the pandemic.

The objective of this study was to systematically assess the literature regarding postnatal healthcare utilization and barriers/facilitators of healthcare in neonatal abstinence syndrome (NAS) children.

A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science to identify peer-reviewed research. Eligible studies were peer-reviewed articles reporting on broad aspects of primary and specialty healthcare utilization and access in NAS children. Three investigators independently reviewed all articles and extracted data. Study bias was assessed using the Newcastle–Ottawa Assessment Scale and the National Institute of Health Study Quality Assessment Tool.

This review identified 14 articles that met criteria. NAS children have poorer outpatient appointment adherence and have a higher rate of being lost to follow-up. These children have overall poorer health indicated by a significantly higher risk of ER visits, hospital readmission, and early childhood mortality compared with non-NAS infants. Intensive multidisciplinary support provided through outpatient weaning programs facilitates healthcare utilization and could serve as a model that could be applied to other healthcare fields to improve the health among this population.

This review investigated the difficulties in accessing outpatient care as well as the utilization of such care for NAS infants. NAS infants tend to have decreased access to and utilization of outpatient healthcare following hospital birth discharge. Outpatient weaning programs have proven to be effective; however, these programs require intensive resources and care coordination that has yet to be implemented into other healthcare areas for NAS children.

Return visits to the emergency department (RTED) for the same clinical complaint occur in 2.7% to 8.1% of children presenting to pediatric emergency departments (PEDs). Most studies examining RTEDs have focused solely on PEDs and do not capture children returning to other local emergency departments (EDs). Our objective was to measure the frequency and characterize the directional pattern of RTED to any of 18 EDs serving a large geographic area for children initially evaluated at a PED.

We conducted a retrospective cohort study of all visits to a referral centre PED between August 2012 and August 2013. We compared demographic variables between children with and without an RTED, measures of flow and disposition outcomes between the initial (index) visit and RTED, and between RTED to the original PED versus to other EDs in the community.

Among all PED visits, 7.6% had an RTED within 7 days, of which 13% were to a facility other than the original PED. Children with an RTED had higher acuity and longer length of stay on their index visit. They were also more likely to be admitted on a subsequent visit than the overall PED population. RTED to the original PED had a longer waiting time (WT), length of stay, and more frequently resulted in hospitalization than RTED to a general ED.

A significant proportion of RTED occur at a site other than where the original ED visit occurred. Examining RTED to and from only PEDs underestimates its burden on emergency health services.

Untreated maternal depression during the postpartum period can have a profound impact on the short- and long-term psychological and physical well-being of children. There is, therefore, an imperative for increased understanding of the determinants of depression and depression-related healthcare access during this period.

Respondents were 11 089 mothers of 9-month-old infants recruited to the Growing Up in Ireland study. Of this sample, 10 827 had complete data on all relevant variables. Respondents provided sociodemographic, socioeconomic and household information, and completed the Center for Epidemiologic Studies Depression Scale (CESD).

11.1% of mothers scored above the CESD threshold for depression. 10.0% of depressed mothers and 25.4% of depressed fathers had depressed partners. Among depressed mothers, 73.1% had not attended a healthcare professional for a mental health problem since the birth of the cohort infant. In the adjusted model, the likelihood of depression was highest in mothers who: had lower educational levels (odds ratio (OR) 1.26; 95% confidence intervals (CIs) 1.08, 1.46); were unemployed (OR 1.27; 95% CIs 1.10, 1.47); reported previous mental health problems (OR 6.55; 95% CIs 5.68, 7.56); reported that the cohort child was the result of an unintended pregnancy (OR 1.43; 95% CIs 1.22, 1.68), was preterm (OR 1.35; 95% CIs 1.07, 1.70), or had health/developmental problems (OR 1.20; 95% CIs 1.04, 1.39); had no partner in the household (OR 1.33; 95% CIs 1.04, 1.70) or were living with a depressed partner (OR 2.66; 95% CIs 1.97, 3.60); reported no family living nearby (OR 1.33; 95% CIs 1.16, 1.54); were in the lowest income group (OR 1.60; 95% CIs 1.21, 2.12). The primary determinant of not seeking treatment for depression was being of non-white ethnicity (OR 2.21; 95% CIs 1.18, 4.13).

Results highlight the prevalence of maternal depression in the later postpartum period, particularly for lower socioeconomic groups, those with previous mental health problems, and those with limited social support. The large proportion of unmet need in depressed mothers, particularly among ethnic minority groups, emphasises the need for a greater awareness of postpartum mental health problems and increased efforts by healthcare professionals to ensure that mothers can access the required services.

To understand the experience of terminal care and health care access for Gypsy Travellers, to inform palliative and primary care service provision.

Little contemporary research of UK English Romany Gypsy Travellers is available. This ethnic group is often overlooked in ethnic minority health research.

Access to Gypsy Traveller communities was through non-health care channels and required the development of trust through repeated contact over time. English Romany Gypsy Travellers at two Traveller sites participated in face-to-face contacts. Data collection was through field observation and seven semistructured interviews with Gypsy Traveller women who had experience of caring for relatives who were dying. In addition, data were collected over two years through discussion in a members-only Gypsy and Traveller interest e-mail forum.

The culture of Gypsy Travellers is distinct but diverse. Hygiene is important as is discretion and sensitivity to the information requirements of the patient and family. Gypsy Travellers are aware that their mobility (voluntary or enforced) can negatively impact on health care. Home care for the terminally ill is often preferred to hospital care often due to poor understanding of their cultural and personal needs by health care professionals and due to an aversion to ‘bricks and mortar’. Care may be provided by the extended family. Palliative care provision should consider the needs of Gypsy Travellers including respect for their culture and support for caring at home.