WASHINGTON, DC—Patients with Parkinson’s disease may have serious comorbidities and complications that require emergency department visits and hospitalizations. “Only 4.5% of hospitalizations of patients with Parkinson’s disease are for management of primary Parkinson’s disease, and most hospitalizations are due to comorbidity or management of complications,” said Alka Mithal, MD, of the Institute of Clinical Outcomes Research and Education in Woodside, California, and colleagues, at the 2017 National Association of Specialty Pharmacy Annual Meeting.
Few studies have examined serious complications and comorbidities of Parkinson’s disease requiring hospitalization. To study emergency department visits and hospitalizations in patients with Parkinson’s disease, Dr. Mithal and colleagues examined the 2014 Nationwide Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS) databases.NEDS, a sample of US hospital-based emergency departments, is the largest all-payer emergency department database in the US. NIS, a stratified random sample of all US community hospitals, is the largest inpatient care database with information on all inpatient care, regardless of insurance status. The investigators calculated prevalence per 100,000 US population. Population data were taken from the US Census Bureau.
In 2014, there were 137.8 million all-cause emergency department visits in the US, with prevalence of 43,219 visits per 100,000 population. Parkinson’s disease accounted for 416,787 emergency department visits (131 visits per 100,000 population). Men accounted for 55% of the visits. Medicare paid for 85% of the visits, and Medicaid paid for 4% of the visits.
Of 272,450 hospitalizations in patients with Parkinson’s disease, approximately 4.5% were directly related to a primary diagnosis of Parkinson’s disease. Men accounted for 57% of hospitalizations (prevalence of 129/100,000 in men older than 18, and 94/100,000 in women older than 18). The average charges per hospitalization were $47,006, with a mean length of stay of 3.8 days. Medicare paid for 87% of these hospitalizations.
In a separate study, Dr. Mithal and colleagues used the 2014 NIS to examine hospitalizations in patients younger than 65 with a diagnosis of Parkinson’s disease. There were 33,650 such hospitalizations (60% men). The mean length of hospitalization was 5.96 days. “Parkinson’s disease and its complications are not limited to the elderly,” the researchers said. “Patients younger than 65 … accounted for over $1.7 billion in hospitalization expenses alone in 2014.”
Acorda Therapeutics funded the studies.