SMALL-AREA VARIATIONS IN UTILIZATION OF ABORTION SERVICES IN ONTARIO FROM 1985 TO 1992

Objective: To assess interregional differences in the utilization of a bortion services in Ontario from 1985 to 1992. Design: Retrospective a nalysis of provincial therapeutic abortion database. Setting: All hosp itals conducting abortions between 1985 and 1992 and all free-standing abortion clinics conducting abortions between 1990 and 1992. Populati on: All women in Ontario aged 15 to 44 years who underwent a therapeut ic abortion in Ontario during the study period. Outcome measures: Util ization of abortion services by county and age-specific abortion rates by county of residence. Results: From 1985 to 1989, when only hospita l data were gathered, the mean therapeutic abortion rate increased by 11.2%. From 1990 to 1992, when data from hospitals and free-standing c linics were collected, the mean rate increased by 26.5%. Logistic regr ession analysis showed significant variation in the age-standardized a bortion rates between counties in each study year (p < 0.0001). The co unties with age-standardized rates below the 25th percentile bad the h ighest proportions of women who sought abortion services outside their county of residence; in some of these counties no abortions were perf ormed in local facilities. Conclusion: There are interregional variati ons in the utilization of abortion services in Ontario. These disparit ies raise questions about the accessibility of abortion services and n eed to be further investigated.