Trends in resource utilization for Parkinson's disease in Germany.
OBJECTIVE
The prevalence of Parkinson's disease (PD) and costs of healthcare resources for this disease have been increasing in recent years. The objective was to determine the trends in the resource utilization for PD in Germany.


METHODS
We compared resource utilization in two cohorts of PD patients recruited in 2000 (n=145) and 2004 (n=133) from two clinical departments, two office-based neurologists and several general practitioners. Direct and indirect costs were assessed based on a patient diary and structured personal interviews. Clinical status was classified in Hoehn and Yahr (HY) stages. Cost-driving factors were determined using multivariate regression analysis.


RESULTS
In 2004, total annual costs for PD ranged from EUR 18,660 for HY I-II to EUR 31,660 for HY II-V. As compared to costs in 2000, total costs increased in 2004 by 25-31%. Drug costs increased by 14-20% during this time. The largest increase in direct costs was observed in the early disease (HY I-II), primarily due to rising costs for inpatient care and drugs. Motor complications, age, HY stage and study year were independent cost-driving factors.


CONCLUSIONS
The resource utilization in PD increased rapidly over the four year study period. Increasing consumption of healthcare resources due to medical progress is a major factor of rising costs. Future studies should attend more to trends in the utilization of healthcare resources and identify factors which could slow down the expanding costs of healthcare.
Winter
Yaroslav
Y
Department of Neurology, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany.
Balzer-Geldsetzer
Monika
M
von Campenhausen
Sonja
S
Spottke
Annika
A
Eggert
Karla
K
Oertel
Wolfgang H
WH
Dodel
Richard
R
D000367:Age Factors; D000978:Antiparkinson Agents / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D018450:Disease Progression; D018491:Dopamine Agonists / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs / Q000639:trends; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000639:trends*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000639:trends; D006801:Humans; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000150:complications / Q000191:economics* / Q000628:therapy*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
D000978:Antiparkinson Agents; D018491:Dopamine Agonists