The Hamburg Parkinson day-clinic: a new treatment concept at the border of in- and outpatient care

Objective To close a gap between inpatient and outpatient care, the Hamburg Parkinson day clinic (HPDC) was developed offering new comprehensive, individual, interdisciplinary type of treatment for patients with complex Parkinsonian syndromes (PS). Methods First, we describe the HPDC concept, in which a multi- professional medical team of PD specialists provides a time- and personnel-wise intensive care and focuses on the patients' individual deficits and resources. Second, we present short-term outcome results of 334 PS patients enrolled during a period of 32 months including objective clinical motor and non-motor scores taken before and after participation in the HPDC as well as the patients' subjective evaluation of the HPDC. Results: Out of the 334 patients with PS (aged 36-87 years with Hoehn and Yahr scores between 1.0 and 4.5), 309 were diagnosed to have Parkinson's disease (PD). HPDC treatment led to improvement in motor function (MDS-UPDRS III) and all investigated non-motor scores (BDI-II, MoCA, PDNMS, PDSS-2, King's PD Pain Scale, QUIP, PDQ-39; p<0.05), indicating benefits regarding akinesia, tremor, dyskinesia, cognition, sleep, pain, impulse control disorders and quality of life. Patients assessed HPDC care positively with values from 1.3 to 2.4 ('very good' to 'satisfying') with an overall grade of 1.5 ('good') on a 6-point Likert scale (16: best to worst). Conclusions Patients with advanced PS benefit from the HPDC concept which is considered to close a gap between inpatient and outpatient care.