1Department of Surgery,Section of Neurosurgery,University of Manitoba,Winnipeg,Manitoba,Canada.
2Faculty of Medicine,University of British Columbia,Vancouver,British Columbia,Canada.
Can J Neurol Sci. 2018 Sep;45(5):553-558. doi: 10.1017/cjn.2018.268.
The Canada Health Act requires reasonable access to all medically necessary therapies. No information is available to assess the current access to neuromodulation across Canada. This study quantifies the current rate of deep brain stimulation (DBS) for the entire country of Canada. Analyses were performed to determine whether there were differences in access based on provincial or territorial location, rural or non-rural region, or socioeconomic status.
All implanted DBS devices in Canada over a 2-year epoch (January 2015 to December 2016) were supplied by either Boston Scientific or Medtronic. Investigators received anonymized data from these companies, including patient age and home residence region. The 2016 Statistics Canada census data were used to determine the rate of DBS surgery and whether access was related to provincial location, rural versus non-rural region or socioeconomic status.
A total of 722 patients were studied. The rate of DBS surgery for the entire country was ten per million population per year. Saskatchewan was significantly above (374%) the national average, whereas Quebec (40%) and Newfoundland & Labrador (32%) were significantly below the national average. No patients from the three territories received DBS. There were no significant differences in access from rural versus non-rural areas or in regions within provinces with different socioeconomic status.
This is the first study to quantify all patients receiving DBS within an entire country. The current rate of DBS surgery within Canada is ten cases per million per year. Statistically significant regional differences were discovered and discussed.
《加拿大健康法案》要求合理获得所有必要的医学治疗。目前尚无信息可评估加拿大各地神经调节治疗的可及性。本研究量化了整个加拿大的深部脑刺激（DBS）的当前使用率。分析旨在确定基于省或地区、农村或非农村地区或社会经济地位的获取途径是否存在差异。
在 2 年的时间范围内（2015 年 1 月至 2016 年 12 月），加拿大所有植入的 DBS 设备均由波士顿科学公司或美敦力公司提供。研究人员从这些公司收到了匿名数据，包括患者年龄和家庭居住地区。使用 2016 年加拿大统计局的人口普查数据来确定 DBS 手术的比例，以及是否与省或地区位置、农村与非农村地区或社会经济地位有关。
共研究了 722 名患者。全国 DBS 手术的比例为每年每百万人中有 10 例。萨斯喀彻温省的比例明显高于全国平均水平（374%），而魁北克省（40%）和纽芬兰和拉布拉多省（32%）则明显低于全国平均水平。三个地区均无患者接受 DBS 治疗。来自农村与非农村地区或具有不同社会经济地位的省份内部地区的获得途径没有显着差异。
这是首次在整个国家内量化接受 DBS 的所有患者的研究。加拿大目前每年每百万人中有 10 例接受 DBS 手术。发现并讨论了具有统计学意义的区域差异。
