Healthcare utilization in patients with Parkinson's disease: A population-based analysis

Purpose: To investigate factors associated with healthcare utilization and prescription drug use for Parkinson's disease (PD) patients and matched controls. Methods: A retrospective matched-group design was adopted using administrative data from Manitoba, Canada. PD cases (N = 1469) were identified from diagnoses in hospital records and physician billing claims and matched to controls (N = 2938) on age, sex, and region of residence. Sixteen measures of healthcare utilization were examined over a six-year period using generalized linear models. Results: PD cases had greater healthcare utilization than controls for almost all investigated services, with the exception of visits to non-neurological specialists and hospital use for non-mental disorder diagnoses. For controls, utilization of all forms of healthcare increased with age; for PD cases the relationship was weak, except for specialist visits, where an inverse relationship was observed. A rural region of residence was associated with a lower rate of seeing a specialist or any medical doctor, with a higher rate of hospitalization than for urban cases or controls. Comorbidity was strongly associated with healthcare use for both groups. Over the six-year study period significant differences in the trend were observed for mental disorder hospitalizations, hospital days, and physician visits. Conclusions: Factors associated with healthcare utilization in PD patients differ from those without PD. This information may help to identify and optimize healthcare services and associated costs for PD patients. (C) 2012 Elsevier Ltd. All rights reserved.