Quality of life, caregiver burden and insurance in patients with Parkinson's disease in Germany.
BACKGROUND
German health politicians claim that maintenance and thus quality of life (QoL) of patients with chronic disease do not differ between the various healthcare insurance systems in Germany. Patient organizations i.e. the Deutsche Parkinson Vereinigung for patients with Parkinson's disease (PD), physicians, patients themselves and their carers controversially discuss this opinion making by politicians.


METHODS
We performed a survey to analyse the relations between QoL, insurance, disability and caregiver burden in 2603 patients with PD and their carers.


RESULTS
Insurance with private reimbursement provides a significant better self-reported patient disability and QoL according to the various employed rating instruments in patients with PD. Government employees with PD, who have additional private insurance, demand for significant shorter intervals of care giving by their carers. In general, caregiver burden did not significantly differ between patients with PD of the different healthcare insurance systems.


CONCLUSIONS
At least in Germany, obligatory medical insurance with associated state regulation of health care is inferior to private reimbursement insurance in various domains of QoL.
Müller
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Department of Neurology, St Josef Hospital, Ruhr University Bochum, Gudrunstrasse, Bochum, Germany. th.mueller@alexius.de
Woitalla
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D
D000368:Aged; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007341:Insurance / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010300:Parkinson Disease / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D013223:Statistics as Topic; D011795:Surveys and Questionnaires