title: The utilisation of one district hospital emergency department by people with Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is the second most common neurodegenerative disorder in Australia and the economic burden is more than $8.3 billion a year and predicted to escalate. However, little is known of the trends and characteristics of people with Parkinson's disease presenting to emergency departments (ED).
  
  
  METHODS
  The study design was a 12 month retrospective medical record audit. The study was conducted in one metropolitan 300 bed district hospital in an outer suburb of Sydney.
  
  
  RESULTS
  One hundred and twenty nine adult patients (0.4%) with PD presented with a mean age of 79.5 years (SD 7.7); all were over 60 years of age. Of the 129 PD patient cases, there were 260 separate ED episodes of care with the majority (n=151; 58.1%) of patients living in the community and presenting with falls (n=108; 41.5%). There was no statistical difference in triage code allocation when comparing PD patients and ED adult patients (over 60years). There was no difference in representation rate when comparing those over 80years (n=128) with those under 80 years (n=132). The average length of stay for PD patient episodes was 323min (SD 225) compared with 193min (SD 136) for ED patients. Younger adult patient episodes (n=132; 51.0%) were admitted to hospital more frequently than those aged over 80 years (Pearson's X2 test 162.2; df 1; p<0.001.
  
  
  CONCLUSIONS
  We identified in this study that people with PD have a high rate of falls, longer length of stay, high admission rate and represent frequently to the ED. Improved detection, management and a multidisciplinary approach for people with PD along with strict medication regime adherence is likely to improve safety, quality of life, reduce symptom aggravation and ongoing risk of falls.
authors.affiliation: Emergency Department, Hornsby Hospital, Australia. Electronic address: Marion.Harris@health.nsw.gov.au.
authors.forename: Marion
authors.initials: M
authors.lastname: Harris
authors.affiliation: Northern Sydney Local Health District, Faculty of Health, University of Technology Sydney, Australia. Electronic address: Margaret.Fry@uts.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006767:Hospitals, District / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010300:Parkinson Disease / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies
keywords: Emergency service; Geriatrics; Neurodegnenerative diseases; Parkinson disease