title: Economic burden associated with Parkinson's disease on elderly Medicare beneficiaries.
abstract: We evaluated medical utilization and economic burden of self-reported Parkinson's disease (PD) on patients and society. Using the 1992-2000 Medicare Current Beneficiary Survey, we compared health care utilization and expenditures (in 2002 U.S. dollars) of Medicare subscribers with and without PD, adjusting for sociodemographic characteristics and comorbidities. PD patients used significantly more health care services of all categories and paid significantly more out of pocket for their medical services than other elderly (mean+/- SE, 5,532 dollars+/- 329 dollars vs. 2,187 dollars+/- 38 dollars; P<0.001). After adjusting for other factors, PD patients had higher annual health care expenses than beneficiaries without PD (18,528 dollars vs. 10,818 dollars; P<0.001). PD patients were more likely to use medical care (OR=3.77; 95% CI=1.44-9.88), in particular for long-term care (OR=3.80; 95% CI=3.02-4.79) and home health care (OR=2.08; 95% CI=1.76-2.46). PD is associated with a significant economic burden to patients and society. Although more research is needed to understand the relationship between PD and medical expenditures and utilization, these findings have important implications for health care providers and payers that serve PD populations.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, NY 14620, USA. katia_noyes@urmc.rochester.edu
authors.forename: Katia
authors.initials: K
authors.lastname: Noyes
authors.forename: Hangsheng
authors.initials: H
authors.lastname: Liu
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.forename: Robert
authors.initials: R
authors.lastname: Holloway
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Dick
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017281:Cost of Illness; D003710:Demography; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data*; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010300:Parkinson Disease / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States