Evaluation of the burden of Parkinson’s disease in Medicare and linked long term care populations

Abstract

Objectives: To examine the economic burden and health care utilization forpatients diagnosed with Parkinson’s disease using linked data from Medicare andthe Long Term Care (LTC) Minimum Data Set (MDS). Methods: Patients wereincluded in the study if they had at least one diagnosis claim for Parkinson’s disease(International Classification of Diseases, 9thRevision, Clinical Modification code 332.xx) during the identification period (01JUL2008-31DEC2010). The first Parkinson’s disease diagnosis claim date was designated as the index date. Patients were requiredto be age ?65 and have continuous health plan enrollment with medical benefitsfor 6 months pre- and post-index date. Residents in a LTC facility were defined asstudy patients using two quarterly assessments recorded in the MDS during the6-month baseline period. Demographic and clinical characteristics and follow-uphealth care costs and utilizations were described. Results: After 1:1 matching,1,620 patients were included in each group (disease and control patients), and thebaseline characteristics were well-balanced. Patients with Parkinson’s diseasewere more likely to have inpatient stays (14.26% vs. 9.51%, p<0.0001), outpatientvisits (47.72% vs. 41.11%, p=0.0002), skilled nursing facility (SNF) visits (20.37% vs.4.51%, p<0.0001), hospice visits (8.64% vs. 1.36%, p<0.0001), and part D pharmacyvisit (62.65% vs. 53.33%, p<0.0001). Compared to control patients, higher all-causehealth care costs were also observed for Parkinson’s disease patients, includinginpatient costs ($2,451 vs. $1,301, p<0.0001), SNF costs ($2,503 vs. $778, p<0.0001),hospice costs ($1,164 vs. $245, p<0.0001), total outpatient costs ($4,477 vs. $1,304,p<0.0001), pharmacy costs ($695 vs. $1,399, p<0.0001) and total costs ($9,775 vs.$5,314, p<0.0001). Conclusions: During a period of 12 months, patients diagnosed with Parkinson’s disease had higher health care utilization and costs thanmatched control patients.