title: A Cross-Sectional Study on Socioeconomic Systems Supporting Outpatients With Parkinson's Disease in Japan.
abstract: OBJECTIVE
  We conducted a cross-sectional study to evaluate the socioeconomic systems supporting outpatients with Parkinson's disease (PD) in Japan.
  
  
  METHODS
  The study was performed in 2013 at two private hospitals and one clinic in Hokkaido Prefecture, Japan. A survey was conducted with 248 consecutive PD patients, and the data from 237 PD outpatients were analyzed after excluding 11 patients who did not meet inclusion criteria. Monthly medical and transportation payments as a PD outpatient were selected as outcome variables, and their association with various explanatory variables, such as utilization of support systems for PD outpatients, were evaluated using logistic regression model analysis.
  
  
  RESULTS
  After controlling for potential confounding variables, the utilization of the system providing financial aid for treatment for patients with intractable disease was significantly inversely associated with monthly medical payment among PD outpatients (OR 0.46; 95% CI, 0.22-0.95). Experience of hospital admission for PD treatment was significantly positively associated with monthly transportation payment (OR 4.74; 95% CI, 2.18-10.32). Monthly medical payment was also significantly positively associated with monthly transportation payment (OR 4.01; 95% CI, 2.23-7.51).
  
  
  CONCLUSIONS
  Use of Japanese public financial support systems may be associated with reductions in medical payments for PD outpatients. However, those systems may not have supported transportation payments, and higher transportation payments may be associated with an increased risk of hospitalization.
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine.
authors.forename: Aiko
authors.initials: A
authors.lastname: Matsushima
authors.forename: Akihisa
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Fumio
authors.initials: F
authors.lastname: Moriwaka
authors.forename: Sanae
authors.initials: S
authors.lastname: Honma
authors.forename: Kazunori
authors.initials: K
authors.lastname: Itoh
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamada
authors.forename: Shun
authors.initials: S
authors.lastname: Shimohama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsushima
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000191:economics* / Q000628:therapy*; D011632:Public Assistance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014186:Transportation / Q000191:economics