Additionally, PD specialist involvement in the management of PD patient care has been found to improve the patient experience in all care settings and stages of care 6. Previous research finds that movement disorder specialists more accurately diagnose PD, especially in earlier stages and atypical presentations, than neurologists without subspecialty training benefits of early detection can include reduced risk of disease progression and improved quality of life 7. As such, diagnosis and care are ideally managed by general neurologists and/or movement disorder specialists in an outpatient setting 5, 6. 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 4. However, few studies have examined the health care utilization patterns of people living with PD on Medicare and how demographic differences, especially for groups that have been historically underrepresented in research, impact utilization of health care services 2, 3. Within the United States, an estimated 89% of those diagnosed with PD are eligible for government-provided Medicare health insurance either because of their age (65 years of age and older) or prolonged disability status 1. Our findings emphasize the need for further research on population-specific barriers to accessing PD-related health care.
Despite 52.9% of beneficiaries being diagnosed with depression, only 1.8% had a clinical psychology visit. People of color and rural residents were least likely to access a neurologist or therapy services.
Few Medicare beneficiaries diagnosed with PD use recommended services such as physical, occupational, or speech therapy. Surprisingly, 40% of PD beneficiaries ( n = 274,046) did not see a neurologist at all during the calendar year and only 9.1% visited a movement disorder specialist (MDS). Our analysis identified significant disparities in care.
By our estimates, PD beneficiaries number 685,116 or 1.2% of the total Medicare population. Here, we analyzed health care utilization patterns of those with a PD diagnosis enrolled in Medicare in 2019.
How these beneficiaries use and engage the health care system is important to understand in the face of a rapidly growing PD population. An estimated 90% of people living with Parkinson’s disease (PD) in the US are covered by Medicare health insurance.
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