title: [Health-economic burden of Parkinson's disease in Portugal: a cohort study].
abstract: BACKGROUND
  Parkinson's disease (PD) is a common neurodegenerative disorder with a considerable socioeconomic burden. Health-economic evaluations of PD in the Southern European countries are limited.
  
  
  OBJECTIVE
  To evaluate the costs of PD in an outpatient cohort in Portugal.
  
  
  METHODS
  49 consecutive PD patients were recruited at the neurological outpatient clinic of the University of Lisbon between October 2004 and December 2005. Clinical status was evaluated using the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stages. Costs were assessed from the societal perspective using health-economic questionnaires. Human capital approach was used to estimate indirect costs. Health-related quality of life was evaluated by means of the EQ-5D.
  
  
  RESULTS
  Direct costs were 2,717 euros (95% CI = 1,147-3,351) per patient for a six-month period. Main contributors to the direct costs included drugs (544 euros; 95% CI = 426-6,940) and hospitalizations (690 euros; 95% CI = 229-1,944). Indirect costs amounted to 850 euros (95% CI = 397-1,529), whereas patient expenditures constituted 12% of direct costs. Assistance by family and other relatives played a major role. In general, costs were lower than in other Western countries.
  
  
  CONCLUSIONS
  The economic burden of PD in Portugal is considerable. Important cost components include medications and hospitalizations. More research is needed in order to describe a comprehensive health service patterns in Portugal and to guide health policy decisions more effectively.
authors.affiliation: Department of Neurology, Philipps, University Marburg, Marburg, Alemania.
authors.forename: J P
authors.initials: JP
authors.lastname: Reese
authors.forename: Y
authors.initials: Y
authors.lastname: Winter
authors.forename: M M
authors.initials: MM
authors.lastname: Rosa
authors.forename: A M
authors.initials: AM
authors.lastname: Rodrigues E Silva
authors.forename: S
authors.initials: S
authors.lastname: von Campenhausen
authors.forename: R
authors.initials: R
authors.lastname: Freire
authors.forename: C
authors.initials: C
authors.lastname: Mateus
authors.forename: M
authors.initials: M
authors.lastname: Balzer-Geldsetzer
authors.forename: K
authors.initials: K
authors.lastname: Botzel
authors.forename: W H
authors.initials: WH
authors.lastname: Oertel
authors.forename: R
authors.initials: R
authors.lastname: Dodel
authors.forename: C
authors.initials: C
authors.lastname: Sampaio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010300:Parkinson Disease / Q000191:economics*; D011174:Portugal; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult