Sex-Specific Patient Journeys in Early Parkinson's Disease in the Netherlands

Objective: To reconstruct a sex-specific patient journey for Dutch persons with Parkinson's disease (PD) during the first 5 years after diagnosis.Method: We analyzed a national administrative medical claims database containing data of all patients newly diagnosed with PD between 2012 and 2016 in the Netherlands. We performed time-to-event analysis to identify the moments when patients received care from neurologists, allied healthcare therapists or general practitioners. We also extracted relevant clinical milestones: unexpected hospitalization for PD, pneumonia, orthopedic injuries, nursing h... Mehr ...

Verfasser: Floris Pieter Vlaanderen
Yvonne de Man
Jesse H. Krijthe
Marit A. C. Tanke
A. S. Groenewoud
Patrick P. T. Jeurissen
Sabine Oertelt-Prigione
Marten Munneke
Bastiaan R. Bloem
Marjan J. Meinders
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: Frontiers in Neurology, Vol 10 (2019)
Verlag/Hrsg.: Frontiers Media S.A.
Schlagwörter: patient journey / Parkinson's disease / sex difference / personalized care / healthcare usage / early Parkinson's disease / Neurology. Diseases of the nervous system / RC346-429
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29172542
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.3389/fneur.2019.00794

Objective: To reconstruct a sex-specific patient journey for Dutch persons with Parkinson's disease (PD) during the first 5 years after diagnosis.Method: We analyzed a national administrative medical claims database containing data of all patients newly diagnosed with PD between 2012 and 2016 in the Netherlands. We performed time-to-event analysis to identify the moments when patients received care from neurologists, allied healthcare therapists or general practitioners. We also extracted relevant clinical milestones: unexpected hospitalization for PD, pneumonia, orthopedic injuries, nursing home admission, and death. Using these data, we constructed the patient journey stratified for sex.Results: We included claims data of 13,518 men and 8,775 women with newly diagnosed PD in the Netherlands. While we found little difference in neurologist consultations, women visited general practitioners and physiotherapists significantly earlier and more often (all p-values < 0.001). After 5 years, 37.9% (n = 3,326) of women had visited an occupational therapist and 18.5% (n = 1,623) a speech and language therapist at least once. This was 33.1% (n = 4,474) and 23.7% (n = 3,204) for men. Approximately 2 years after diagnosis, PD-related complications (pneumonia, orthopedic injuries, and PD-related hospitalization) occurred for the first time (women: 1.8 years; men: 2.3 years), and after 5 years, 72.9% (n = 6,397) of women, and 68.7% (n = 9,287) of men had experienced at least one.Discussion: Considering the strengths and limitations of our methods, our findings suggest that women experience complications and access most healthcare services sooner after diagnosis and more frequently than men. The identified sex differences extend the debate about phenotypical differences in PD between men and women.