A study published last month in npj Parkinson’s Disease highlights disparities in health care utilization among patients with Parkinson’s disease and calls for further research on barriers to care for underserved populations. The retrospective, observational study used Medicare data from 2019 to analyze health care utilization in 685,116 patients with Parkinson’s disease (1.2% of the overall Medicare population) based on demographic parameters including age, race, and geography.
Researchers found that patients with Parkinson’s disease tended to be older, were more likely to be male, and were slightly more likely to live in rural areas compared to the Medicare population as a whole. The majority of the Parkinson’s population was White (85.3%); 2.3% were Asian, 5.9% were Black, 2.6% were Hispanic, and 0.3% were North American Native.
Key findings included:
- 60% of the Medicare Parkinson’s population had seen a neurology specialist or movement disorder specialist at least once in 2019
- The remaining 40% either saw a primary care physician or did not see a physician at all
- Asian, Black, Hispanic, and North American Native patients were significantly less likely to utilize specialty care than White patients
- Those living in rural areas were less likely to see a movement disorder specialist than those in urban areas
- Those who received specialist care were more likely to use speech, occupational, or physical therapy and mental health services; those seeing a movement disorder specialist were the most likely to access these services
- Although 52.9% of patients with Parkinson’s had been diagnosed with depression and/or anxiety, only 1.8% and 3.9% had at least one visit with a clinical psychologist or psychiatrist, respectively
The authors note “…persistent health disparities for women, people of color, and rural residents—each of whom may face challenges with PD diagnosis and access to treatment.” As the population ages and the cohort of patients with Parkinson’s grows, disparities in health care utilization will become more pronounced. And given that early detection of Parkinson’s disease and subsequent intervention can improve patients’ quality of life and reduce the risk of disease progression, these findings are especially concerning and underscore the need for accessible diagnostic tools.
“Inconsistent symptom presentation and disease progression, as well as lack of biomarker or objective clinical diagnostic test to diagnose disease, creates a challenge for diagnosing and treating PD, especially for physicians with less expertise in movement disorders.”
