Predictors of health care use in patients with Parkinson's disease: A longitudinal study

PURPOSE: To predict health care use in patients with Parkinson's disease. METHODS: The health care use of 235 patients with Parkinson's disease was s tudied twice over the course of 1 year. Use consisted of visits to the neur ologist and general practitioner (GP) and use of a physiotherapist, a psych otherapist, or home care nurse. The effects of both prior and concurrent so ciodemographic, disease-related, and psychosocial characteristics on health care use were examined. RESULTS: Patients who were living with others and patients with private hea lth insurance paid significantly (p <0.01) more visits to their neurologist s. For visits to the general practitioner, disease severity and poor qualit y of life, as measured by the Parkinson's Disease Quality of Life questionn aire (PDQL), were the most important predictors. Other sociodemographic and disease-related characteristics, such as age, gender, and disease duration , were not related to doctor visits. Physiotherapy was associated with dise ase severity and poor quality of life. Lack of social support, depression, and poor quality of life were correlated with psychotherapy, whereas age, f emale gender, living alone, disease severity, and disease duration were rel ated to use of a home carl nurse. CONCLUSIONS: The number of visits to a neurologist by patients with PD is n ot associated with disease severity or quality of life impairment, but only with sociodemographic characteristics. Nonmedical care is predicted by dis ease severity and psychosocial characteristics. The consequences for care a nd costs are discussed.