Sex disparities in access to caregiving in Parkinson disease

Dahodwala, Nabila; Shah, Kavisha; He, Yi; Wu, Samuel S.; Schmidt, Péter; Cubillos, Fernando; Willis, Allison W.

doi:10.1212/wnl.0000000000004764

Cited by 82 publications

(65 citation statements)

References 35 publications

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“…Recent data suggests that current payer models and care patterns do not meet the needs of women with PD, who have less access to specialized care and greater unreimbursed care needs. 13,30 Improving PD outcomes will require increased attention to women with PD, from both research and clinical perspectives, especially given that almost half of the Medicare PD population is made up of women.…”

Section: Discussionmentioning

confidence: 99%

State-level prevalence, health service use, and spending vary widely among Medicare beneficiaries with Parkinson disease

Mantri

Fullard

Beck

et al. 2019

npj Parkinson's Disease

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State-level variations in disease, healthcare utilization, and spending influence healthcare planning at federal and state levels and should be examined to understand national disparities in health outcomes. This descriptive study examined state-level variations in Parkinson disease (PD) prevalence, patient characteristics, Medicare spending, out-of-pocket costs, and health service utilization using data on 27.5 million Medicare beneficiaries in the US in 2014. We found that 45.8% (n = 179,496) of Medicare beneficiaries diagnosed with PD were women; 26.1% (n = 102,205) were aged 85+. The District of Columbia, New York, Illinois, Connecticut, and Florida had the highest age-, race-, and sex-adjusted prevalence of Parkinson disease among Medicare beneficiaries in the US. Women comprised over 48.5% of PD patient populations in West Virginia, Kentucky, Mississippi, Louisiana, and Arkansas. More than 31% of the PD populations in Connecticut, Pennsylvania, Hawaii, and Rhode Island were aged 85+. PD patients who were “dual-eligible”—receiving both Medicare and Medicaid benefits—also varied by state, from <10% to >25%. Hospitalizations varied from 304 to 653 stays per 1000 PD patients and accounted for 26.5% of the 7.9 billion United States Dollars (USD) paid by the Medicare program for healthcare services delivered to our sample. A diagnosis of PD was associated with greater healthcare use and spending. This study provides initial evidence of substantial geographic variation in PD patient characteristics, health service use, and spending. Further study is necessary to inform the development of state- and federal-level health policies that are cost-efficient and support desired outcomes for PD patients.

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Section: Discussionmentioning

confidence: 99%

State-level prevalence, health service use, and spending vary widely among Medicare beneficiaries with Parkinson disease

Mantri

Fullard

Beck

et al. 2019

npj Parkinson's Disease

Self Cite

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“…Neurokognitive Beeinträchtigungen [34,[52][53][54][55] Neuropsychiatrische Symptome, wie Depression, Angst, Apathie, Mangel an Empathie, Aggression, Halluzinationen und Impuls-Kontrollstörungen [15,33,[55][56][57][58][59][60] Nächtliche Symptome, inklusive Pollakisurie und Inkontinenz [61,62] Schlafstörungen [15,36] Autonome Störungen (z.B. orthostatische Hypotonie) [15] Dauer und Schweregrad motorischer Symptome, inklusive Fluktuationen sowie L-Dopa-Äquivalenzdosis und, indirekt, Therapie-Misserfolg (neuerer Therapien) [12, 33, 35-50, 63, 64] Komorbiditäten [65] Beeinträchtigungen in Alltagsaktivitäten und Abhängigkeit des Pfleglings von der Pflegeperson [15,25,33,66] Männliches Geschlecht [15,65] ▶Tab. 2 Faktoren der Betreuungsbelastung vonseiten der Betreuungsperson Betreuerin (i.V.…”

Section: Literaturrecherche Und Analyseunclassified

“…2 Faktoren der Betreuungsbelastung vonseiten der Betreuungsperson Betreuerin (i.V. zu Betreuer) [22,65] Pflegedauer, nächtliche Pflege [15,34] Ökonomische Belastungen [67,68] Mangel an soziale Unterstützung [66,69] Beeinträchtigung der psychischen Gesundheit (Depression, Angst, Stress), negative Emotionen und belastete emotionale Beziehung zum Pflegling [14,34,37,66,70] ▶Tab.…”

Section: Literaturrecherche Und Analyseunclassified

Belastungen in der Betreuung von Parkinson-Patientinnen und - Patienten

Ransmayr¹

2020

Fortschr Neurol Psychiatr

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ZusammenfassungPatientinnen und Patienten (Pat.) mit Parkinson-Krankheit bedürfen mit zunehmender Krankheitsdauer und Schweregrad persönlicher Betreuung, die meist von weiblichen Angehörigen gewährleistet wird. Die Belastungen für pflegende Angehörige resultieren einerseits aus den motorischen Beeinträchtigungen der Pat., andererseits von neurokognitiven und neuropsychiatrischen Symptomen sowie Verhaltensstörungen, Störungen des autonomen Nervensystems, der Miktion, des Schlafes und der Selbstständigkeit. Gesundheitliche Probleme der Betreuungsperson, u. a. Depression und Angst, emotionale Probleme mit dem Pflegling, Beeinträchtigung des Schlafs, sowie Einschränkungen in persönlichen Anliegen, Beruf, Familie, Freizeitgestaltung, sozialen Aktivitäten, finanzielle Einbußen und mangelhafte soziale Unterstützung stellen weitere Belastungsfaktoren dar. Personen mit dem Risiko einer erheblichen Betreuungsbelastung sind frühzeitig zu identifizieren, um ihnen Informationen über die Krankheit und Unterstützungsmöglichkeiten sowie entsprechende personelle, psychologische und finanzielle Unterstützung zukommen zu lassen.

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“…Together with aging, genetics, environment and immune status, the role of biological sex as an important factor in the development of PD has been widely discussed in the past decade. There are clear sexrelated differences in epidemiological and clinical features of the disease: PD affects men twice more often than women [4,5], but women have a higher mortality rate and faster progression of the disease [6]. Moreover, women show distinctive symptoms as well as differences in the response to pharmacolog-ical therapies and deep brain stimulation procedure, and in the personal evaluation of the quality of life compared with men [7].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, more women use paid caregiver services than men. The reasons for this discrepancy may be linked to the longer average lifespan of women and their natural inclination toward being caregivers rather than receivers of care, even when their spouse or caregiver is still present in their lives [6].…”

Section: Introductionmentioning

confidence: 99%

Parkinson’s Disease in Women and Men: What’s the Difference?

Cerri¹,

Mus²,

Blandini³

2019

Journal of Parkinson’s Disease

484

309

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Increasing evidence points to biological sex as an important factor in the development and phenotypical expression of Parkinson's disease (PD). Risk of developing PD is twice as high in men than women, but women have a higher mortality rate and faster progression of the disease. Moreover, motor and nonmotor symptoms, response to treatments and disease risk factors differ between women and men. Altogether, sex-related differences in PD support the idea that disease development might involve distinct pathogenic mechanisms (or the same mechanism but in a different way) in male and female patients. This review summarizes the most recent knowledge concerning differences between women and men in PD clinical features, risk factors, response to treatments and mechanisms underlying the disease pathophysiology. Unraveling how the pathology differently affect the two sexes might allow the development of tailored interventions and the design of innovative programs that meet the distinct needs of men and women, improving patient care.

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Sex disparities in access to caregiving in Parkinson disease

Cited by 82 publications

References 35 publications

State-level prevalence, health service use, and spending vary widely among Medicare beneficiaries with Parkinson disease

State-level prevalence, health service use, and spending vary widely among Medicare beneficiaries with Parkinson disease

Belastungen in der Betreuung von Parkinson-Patientinnen und - Patienten

Parkinson’s Disease in Women and Men: What’s the Difference?

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