Small-area variations in utilization of abortion services in Ontario from 1985 to 1992.

Abstract

To assess interregional differences in the utilization of abortion services in Ontario from 1985 to 1992. Retrospective analysis of provincial therapeutic abortion database. All hospitals conducting abortions between 1985 and 1992 and all free-standing abortion clinics conducting abortions between 1990 and 1992. All women in Ontario aged 15 to 44 years who underwent a therapeutic abortion in Ontario during the study period. Utilization of abortion services by county and age-specific abortion rates by county of residence. From 1985 to 1989, when only hospital data were gathered, the mean therapeutic abortion rate increased by 11.2%. From 1990 to 1992, when data from hospitals and free-standing clinics were collected, the mean rate increased by 26.5%. Logistic regression analysis showed significant variation in the age-standardized abortion rates between counties in each study year (p < 0.0001). The counties with age-standardized rates below the 25th percentile had the highest proportions of women who sought abortion services outside their county of residence; in some of these counties no abortions were performed in local facilities. There are interregional variations in the utilization of abortion services in Ontario. These disparities raise questions about the accessibility of abortion services and need to be further investigated.