Disability and use of healthcare resources in Brazilian patients with Parkinson's disease.

Abstract

To assess disability and healthcare resource use in Parkinson's disease (PD) patients. A cross-sectional survey of 144 Brazilian PD patients consecutively admitted at a Neurological outpatient clinic. Clinical evaluation was done using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn & Yahr staging (H&Y). The Schwab and England (SE) activity of daily living (ADL) scale was used to assess the level of dependence in the ADL. Information about the utilization of health resources was obtained interviewing the patient by means of a structured questionnaire. A total of 66% of patients (mean age 62 years; males, 53%) had a Hoehn & Yahr stage < or = 2. Mean UPDRS score was 46.2, and median SE scale score was 80. Disabled PD patients significantly received more visits by a general practitioner (p < 0.001). Patients with comorbid conditions significantly used more domiciliary nurse care and physiotherapist assistance (p < 0.01). The most frequent reason for hospitalization was the treatment of clinical complications and drug dose adjustment. Pharmacological treatment costs were associated with the severity of the disease (p < 0.05). Utilization of healthcare resources was influenced by functional status and comorbid conditions.