U.S. Parkinson’s disease patients being covered by Medicare health insurance are experiencing significant gaps and disparities in their care compared with non-Medicare patients, according to results from a Parkinson’s Foundation and University of Chicago study.
As reported in the npj Parkinson’s Disease journal, 90% of U.S. Parkinson’s disease patients are eligible for Medicare health insurance. The researchers found that 40% of Medicare covered Parkinson’s patients did not see a neurologist at all during 2019 and only 9.1% visited a movement disorder specialist.
Physical, occupational, or speech therapy are recommended services for many people with Parkinson’s, but these were rarely used by this group. Despite over half the Medicare Parkinson’s group having a diagnosis of depression, less than four percent saw a clinical psychologist or psychiatrist during the year.
Notably, people of color or those living in rural areas were even less likely to access neurology or other therapy service than other Medicare patients with the condition.
“This impactful analysis reveals the significant gaps in access to both recommended and best practice care for Parkinson’s disease,” said co-author Allison Willis, an associate professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania, in a press statement.
“Our scientific reporting and understanding of Parkinson’s disease has focused on specialty center populations, which these data suggest are a minority of the Parkinson’s disease population. Persons who are not accessing recommended or best practice care are likely to experience Parkinson’s disease very differently.”
The study used data from 2019 collected from Parkinson’s disease patients covered by Medicare, a group of approximately 685,116 individuals or 1.2% of the total Medicare population. Around 89% of Parkinson’s patients in the U.S. are estimated to be eligible for Medicare due to their age and/or prolonged disability status. The researchers chose to focus on 2019 to avoid inevitable changes to claims data during the COVID-19 pandemic.
Of the group analyzed in this study, 56% were male, 78% over the age of 70 years, 15% were people of color and 16% lived in a rural area. People were included in the study if they had at least one claim related to Parkinson’s disease.
Around 60% of the group saw a neurologist at least once in 2019, but only 9% of the group saw a movement disorder specialist. Women, those older than 70 years, people of color, and those living in a rural area were less likely to see a movement disorder specialist during the year at 8.4%, 8.5%, 4.6–7.8%, and 7.2%, respectively. Approximately 40% of Medicare Parkinson’s patients did not see a neurology specialist and instead saw their primary care physician or no clinician at all during the year.
“While a lot of work remains in order to provide expanded care services for people and families living with PD, this is a critical step in understanding the disparities in access to expert care across populations,” said Ted Thompson, Michael J. Fox Foundation for Parkinson’s Research senior vice president of public policy.
“Studies like this can paint a fuller picture on the public policy priorities that all people with PD and their families need to live a better quality of life with the disease.”
