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Comparative Study
. 2011 Aug 30;77(9):851-7.
doi: 10.1212/WNL.0b013e31822c9123. Epub 2011 Aug 10.

Neurologist care in Parkinson disease: a utilization, outcomes, and survival study

A W Willis  1 , M Schootman, B A Evanoff, J S Perlmutter, B A Racette
Affiliations
Comparative Study

Neurologist care in Parkinson disease: a utilization, outcomes, and survival study

A W Willis et al. Neurology. .

Abstract

Objective: To investigate the utilization of neurologist providers in the treatment of patients with Parkinson disease (PD) in the United States and determine whether neurologist treatment is associated with improved clinical outcomes.

Methods: This was a retrospective observational cohort study of Medicare beneficiaries with PD in the year 2002. Multilevel logistic regression was used to determine which patient characteristics predicted neurologist care between 2002 and 2005 and compare the age, race, sex, and comorbidity-adjusted annual risk of skilled nursing facility placement and hip fracture between neurologist- and primary care physician-treated patients with PD. Cox proportional hazards models were used to determine the adjusted 6-year risk of death using incident PD cases, stratified by physician specialty.

Results: More than 138,000 incident PD cases were identified. Only 58% of patients with PD received neurologist care between 2002 and 2005. Race and sex were significant demographic predictors of neurologist treatment: women (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.76-0.80) and nonwhites (OR 0.83, 95% CI 0.79-0.87) were less likely to be treated by a neurologist. Neurologist-treated patients were less likely to be placed in a skilled nursing facility (OR 0.79, 95% CI 0.77-0.82) and had a lower risk of hip fracture (OR 0.86, 95% CI 0.80-0.92) in logistic regression models that included demographic, clinical, and socioeconomic covariates. Neurologist-treated patients also had a lower adjusted likelihood of death (hazard ratio 0.78, 95% CI 0.77-0.79).

Conclusions: Women and minorities with PD obtain specialist care less often than white men. Neurologist care of patients with PD may be associated with improved selected clinical outcomes and greater survival.

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Figures

Figure
Figure. Survival of Medicare beneficiaries with incident Parkinson disease stratified by treating physician specialty, adjusted for race, age, sex, comorbidity index, and socioeconomic deprivation
*Physicians in the following specialties: internal medicine, family practice, or geriatric medicine.
See this image and copyright information in PMC

Comment in

References

    1. Coeytaux RR, Linville JC. Chronic daily headache in a primary care population: prevalence and headache impact test scores. Headache 2007;47:7–12 - PubMed
    1. MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 2000;123:665–676 - PubMed
    1. Maarsingh OR, Dros J, Schellevis FG, van Weert HC, Bindels PJ, Horst HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract 2010;11:2. - PMC - PubMed
    1. Flanagan E, Walsh C, Tubridy N. ‘Neurophobia': attitudes of medical students and doctors in Ireland to neurological teaching. Eur J Neurol 2007;14:1109–1112 - PubMed
    1. Jozefowicz RF. Neurophobia: the fear of neurology among medical students. Arch Neurol 1994;51:328–329 - PubMed

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