Determining the impact of specialized care on health outcomes and health care utilization in Parkinsonism.
Health care outcomes
Interdisciplinary care
Models of care
Movement disorders
Parkinson disease
Parkinsonism
Journal
Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583
Informations de publication
Date de publication:
10 Feb 2024
10 Feb 2024
Historique:
received:
11
08
2023
revised:
11
01
2024
accepted:
01
02
2024
medline:
19
2
2024
pubmed:
19
2
2024
entrez:
18
2
2024
Statut:
aheadofprint
Résumé
Although care of Parkinsonism (PKM) is assumed to be optimally provided by movement disorder neurologists within an interdisciplinary clinic model, there is a paucity of published data to support this. To investigate the impact of movement disorder neurologist care of individuals with Parkinsonism (PKM). A retrospective exposure design was adopted using administrative data. Incident PKM individuals were identified in billing claims. A nine-year exposure period to movement disorder neurologist, general neurologist and non-neurologist care was calculated based on the billing codes. Regression models were used to test the association of provider exposure on time to death and long-term care (LTC) admission. Linear models were used to test varying provider exposure and hospital admissions, hospital days and emergency department visits. 1914 incident individuals were identified. There was no difference in PKM mortality, emergency visits, hospital admissions, or hospital days between providers, however exposure to general neurology and non-neurology care was associated with a significantly higher risk of admission to LTC compared to movement disorder neurologist care (HR 1.43; 95% CI 1.09-1.87 for general neurology (p-value = 0.0089); HR 1.61; 95% CI 1.25-2.05 for non-neurology (p-value = 0.0002), respectively. Movement disorder neurologist care is associated with a lower risk of admission to LTC over general neurologist care in individuals with PKM.
Sections du résumé
BACKGROUND
BACKGROUND
Although care of Parkinsonism (PKM) is assumed to be optimally provided by movement disorder neurologists within an interdisciplinary clinic model, there is a paucity of published data to support this.
OBJECTIVES
OBJECTIVE
To investigate the impact of movement disorder neurologist care of individuals with Parkinsonism (PKM).
METHODS
METHODS
A retrospective exposure design was adopted using administrative data. Incident PKM individuals were identified in billing claims. A nine-year exposure period to movement disorder neurologist, general neurologist and non-neurologist care was calculated based on the billing codes. Regression models were used to test the association of provider exposure on time to death and long-term care (LTC) admission. Linear models were used to test varying provider exposure and hospital admissions, hospital days and emergency department visits.
RESULTS
RESULTS
1914 incident individuals were identified. There was no difference in PKM mortality, emergency visits, hospital admissions, or hospital days between providers, however exposure to general neurology and non-neurology care was associated with a significantly higher risk of admission to LTC compared to movement disorder neurologist care (HR 1.43; 95% CI 1.09-1.87 for general neurology (p-value = 0.0089); HR 1.61; 95% CI 1.25-2.05 for non-neurology (p-value = 0.0002), respectively.
CONCLUSION
CONCLUSIONS
Movement disorder neurologist care is associated with a lower risk of admission to LTC over general neurologist care in individuals with PKM.
Identifiants
pubmed: 38369425
pii: S1353-8020(24)00038-5
doi: 10.1016/j.parkreldis.2024.106026
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106026Informations de copyright
Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The author group has no competing interest in regard to this manuscript. No AI was used during the creation of this submission. Financial disclosures are individually listed in each author's declaration. There is no conflict of interest relating to those mentioned that pertain to the content within this submission.