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Young-onset Parkinson's disease: Hospital utilization and medical comorbidity in a nationwide survey

Authors

  • Elan D. Louis MD, MSc,

    Corresponding author
    1. GH Sergievsky Center, Columbia University, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    • Unit 198, Neurological Institute, 710 West 168th Street, New York, NY, 10032
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  • Claire Henchcliffe MD, DPhil,

    1. Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, New York, USA
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  • Brian T. Bateman MD,

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • H. Christian Schumacher MD

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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Abstract

Approximately 10% of Parkinson's disease (PD) patients have young-onset PD (YOPD). From a public health perspective, YOPD is an important subgroup of PD patients, because they are expected to remain active users of the health care system for many decades. Health care utilization and medical comorbidity during hospitalization have not been assessed in these patients. The objectives of this study were to compare YOPD patients to control patients in terms of (1) hospital utilization and outcomes, and (2) medical comorbidities during hospitalization. The Nationwide Inpatient Sample (NIS) provides yearly data on hospital admissions and discharges from approximately 1,000 hospitals. NIS data sets (1998–2003) were used to identify persons 18 to 40 years of age, including 714 PD patients and 2,007 randomly selected control patients (1:3 ratio). Hospital length of stay (P < 0.001) and number of discharge diagnoses (P < 0.001) were higher in PD than control patients. PD patients were more likely than controls to be discharged to a short-term hospital (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.30–3.84; P = 0.004) or a skilled nursing facility (OR, 4.14; 95% CI, 3.06–5.61; P < 0.001); 20.4% required transfer to a short-term hospital or another facility. The most common discharge diagnosis-related group code in PD patients was psychosis (23% of patients), whereas pneumonia and hip or pelvic fractures were not associated with PD. YOPD patients had greater health care utilization and hospital morbidity than controls. Upon discharge, 1 in 5 required transfer to a short-term hospital or another facility. Psychosis was the most common comorbidity, whereas several comorbidities associated with older PD patients (e.g., fractures) were not common. © 2006 Movement Disorder Society

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