title: Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain.
abstract: BACKGROUND
  This epidemiological survey estimates the hospitalization burden related to Parkinson´s Disease in Spain.
  
  
  METHODS
  This observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98% of Spanish hospitals. All hospitalizations of patients with Parkinson´s disease that were reported from 1997-2012 were analyzed. Codes were selected using the 9th International Classification of Diseases: ICD-9-CM: 332.0.
  
  
  RESULTS
  A total of 438,513 hospital discharges of patients with Parkinson´s Disease were reported during the study period. The annual hospitalization rate was 64.2 cases per 100,000. The average length of hospital stay was 10 days. The trend for the annual hospitalization rate differed significantly depending on whether Parkinson´s disease was the main cause of hospitalization (n = 23,086, 1.14% annual increase) or was not the main cause of hospitalization (n = 415,427, 15.37% annual increase). The overall case-fatality rate among hospitalized patients was 10%. The case fatality rate among patient´s hospitalized with Parkinson´s disease as the main cause of hospitalization was 2.5%. The hospitalization rate and case-fatality rate significantly increased with age. The primary causes of hospitalization when Parkinson´s disease was not coded as the main cause of hospitalization were as follows: respiratory system diseases (24%), circulatory system diseases (19%), injuries and poisoning, including fractures (12%), diseases of the digestive system (10%) and neoplasms (5%). The annual average cost for National Health Care System was € 120 M, with a mean hospitalization cost of €4,378.
  
  
  CONCLUSIONS
  Parkinson´s disease poses a significant health threat in Spain, particularly in the elderly. While hospitalizations due to Parkinson´s Disease are relatively stable over time, the number of patients presenting with Parkinson´s disease as an important comorbidity has increased dramatically. Medical staff must be specifically trained to treat the particular needs of hospitalized patients suffering from Parkinson´s disease as an important comorbidity.
authors.affiliation: Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain.|Catedra de Evaluación de Resultados en Salud, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Gil-Prieto
authors.affiliation: Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Pascual-Garcia
authors.affiliation: Area of Medicine, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: San-Roman-Montero
authors.affiliation: National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.affiliation: Department of Preventive Medicine & Public Health, Valladolid University, Valladolid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Castrodeza-Sanz
authors.affiliation: Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain.|Catedra de Evaluación de Resultados en Salud, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Gil-de-Miguel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004066:Digestive System Diseases / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology; D010300:Parkinson Disease / Q000453:epidemiology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D012120:Respiration Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology