Abstract
ObjectivesWe conducted a cross-sectional study to evaluate the socioeconomic systems supporting outpatients with Parkinson’s disease (PD) in Japan.MethodsThe study was performed in 2013 at two private hospitals and one clinic in Hokkaido Prefecture, Japan. A survey was conducted with 248 consecutive PD patients, and the data from 237 PD outpatients were analyzed after excluding 11 patients who did not meet inclusion criteria. Monthly medical and transportation payments as a PD outpatient were selected as outcome variables, and their association with various explanatory variables, such as utilization of support systems for PD outpatients, were evaluated using logistic regression model analysis.ResultsAfter controlling for potential confounding variables, the utilization of the system providing financial aid for treatment for patients with intractable disease was significantly inversely associated with monthly medical payment among PD outpatients (OR 0.46; 95% CI, 0.22–0.95). Experience of hospital admission for PD treatment was significantly positively associated with monthly transportation payment (OR 4.74; 95% CI, 2.18–10.32). Monthly medical payment was also significantly positively associated with monthly transportation payment (OR 4.01; 95% CI, 2.23–7.51).ConclusionsUse of Japanese public financial support systems may be associated with reductions in medical payments for PD outpatients. However, those systems may not have supported transportation payments, and higher transportation payments may be associated with an increased risk of hospitalization.
Highlights
Parkinson’s disease (PD) is one of the most common progressive and disabling neurological disorders throughout the world
The system for patients with an intractable disease receiving financial aid for treatment started for PD patients in 1978,13 and utilization of this system was significantly inversely associated with monthly medical payment in our study, even after adjustment for potential confounding variables
This system might be effective in the reduction of payments among PD patients, especially in advanced PD patients with higher medical payments
Summary
Parkinson’s disease (PD) is one of the most common progressive and disabling neurological disorders throughout the world. Finding employment is difficult for PD patients because of physical impairment, and their incomes tend to be reduced,[6] medical costs for the treatment of PD as well as for daily care tend to be relatively high.[7,8,9] Elderly patients with PD are reported to have 84% greater total expenditures compared to those without PD in the United States.[8] PD patients have been reported to use significantly more health care services across all categories and pay significantly more out of pocket for their medical services than other elderly individuals.[10] PD has been shown to have a chronic course with growing disability and considerable socioeconomic burden in Germany, as well.[11]
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