title: Parkinson's Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries.
abstract: This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years) with Parkinson's disease (PD) compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.
authors.affiliation: Department of Pharmacy Practice and Science, School of Pharmacy, The University of Arizona, Tucson, AZ 85721, USA.
authors.forename: Sandipan
authors.initials: S
authors.lastname: Bhattacharjee
authors.affiliation: Department of Life-Span Developmental Psychology, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Metzger
authors.affiliation: Department of Pharmaceutical Systems & Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Tworek
authors.affiliation: Sanofi US, Bridgewater, NJ 08807, USA.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Wei
authors.affiliation: Evidera, Lexington, MA 02420, USA.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Pharmaceutical Systems & Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Sambamoorthi