title: Predictors of health care use in patients with Parkinson's disease: a longitudinal study.
abstract: OBJECTIVE
  To predict health care use in patients with Parkinson's disease.
  
  
  METHODS
  The health care use of 235 patients with Parkinson's disease was studied twice over the course of 1 year. Use consisted of visits to the neurologist and general practitioner (GP) and use of a physiotherapist, a psychotherapist, or home care nurse. The effects of both prior and concurrent sociodemographic, disease-related, and psychosocial characteristics on health care use were examined.
  
  
  RESULTS
  Patients who were living with others and patients with private health insurance paid significantly (p <0.01) more visits to their neurologists. For visits to the general practitioner, disease severity and poor quality of life, as measured by the Parkinson's Disease Quality of Life questionnaire (PDQL), were the most important predictors. Other sociodemographic and disease-related characteristics, such as age, gender, and disease duration, were not related to doctor visits. Physiotherapy was associated with disease severity and poor quality of life. Lack of social support, depression, and poor quality of life were correlated with psychotherapy, whereas age, female gender, living alone, disease severity, and disease duration were related to use of a home care nurse.
  
  
  CONCLUSIONS
  The number of visits to a neurologist by patients with PD is not associated with disease severity or quality of life impairment, but only with sociodemographic characteristics. Nonmedical care is predicted by disease severity and psychosocial characteristics. The consequences for care and costs are discussed.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: de Boer
authors.forename: M A
authors.initials: MA
authors.lastname: Sprangers
authors.forename: H D
authors.initials: HD
authors.lastname: Speelman
authors.forename: H C
authors.initials: HC
authors.lastname: de Haes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D026741:Physical Therapy Modalities / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States