[Characteristics and dynamics of inpatient treatment of patients with Parkinson's disease in Germany : Analysis of 1.5 million patient cases from 2010 to 2015]

Abstract

Background: Parkinson's disease is the most common neurodegenerative movement disorder and the fastest-growing neurological disease in the world. The diagnostic spectrum, demographic characteristics, comorbidities and case number developments of inpatient treatment in Germany with resulting implications for patient care have so far been insufficiently investigated.

Methods: Data from the diagnosis-related groups (DRG) statistics were analyzed in patients with a main and secondary diagnosis of primary Parkinson's syndrome (PS), secondary PS or other degenerative disease of the basal ganglia. For the reporting years 2010-2015, the dataset comprised 1,520,366 patient cases from 413 districts/independent cities throughout Germany.

Results: In 2015, mostly patients with moderate and severe primary PS were hospitalized (64.7%) often exhibiting motor fluctuations as well as marked medical and psychiatric comorbidities. Vascular parkinsonism was the most frequent secondary PS (36.6%) and progressive supranuclear palsy was the leading diagnosis in the other disorders of the basal ganglia (51.9%). Primary PS as a secondary diagnosis was found in many internal medicine hospitalizations. The inpatient case numbers for primary PS increased significantly from the years 2010 to 2015 and rural regions were particularly affected.

Conclusion: The number of inpatient cases of Parkinson's disease is greatly increasing in Germany and mainly affects patients with severe motor complications and secondary parkinsonian syndromes. Particularly in rural areas, there is a risk of overburdening the treatment infrastructure, so that both outpatient and inpatient sectors must be strengthened. A limitation of the study is the analysis of only DRG coded data, whose quality could be improved in subsequent examinations by comparison with the current diagnostic criteria of the specialist societies.

Keywords: Atypical Parkinson’s disease; Epidemiology; Inpatient care; Outpatient care; Parkinson’s disease.