Race, Gender Discrepancies in Neurologist Care for Parkinson's

Women, nonwhites less likely to receive neurologist care for Parkinson's disease

WEDNESDAY, Aug. 10 (HealthDay News) -- Women and nonwhite patients with Parkinson's disease (PD) are less likely to receive neurologist care than white men, and patients receiving neurologist care may have improved selected clinical outcomes and a lower likelihood of death, according to a study published online Aug. 10 in Neurology.

Allison Wright Willis, M.D., from the Washington University School of Medicine in St. Louis, and colleagues investigated the utilization of neurologist providers for treating patients with PD, and evaluated whether neurologists' involvement is associated with improved clinical outcomes in a retrospective study of more than 138,000 Medicare beneficiaries with PD. Data from 2002 to 2005 were analyzed to assess which patient factors predicted neurologist care, and to compare patients treated by neurologists with those treated by primary care physicians for age, gender, race, comorbidity-adjusted risk of skilled nursing facility placement rates, and rates of hip fracture. The adjusted six-year risk of death, categorized by physician specialty, was determined.

The investigators found that 58 percent of patients identified with PD received neurologist care. Race and gender were significant predictors of neurologist care, with women and nonwhites less likely to receive neurologist treatment (odds ratio [OR], 0.78 and 0.83, respectively). Compared with primary care physician-treated patients, patients who received neurologist care had a significantly lower likelihood of being placed in a skilled-nursing facility and had a significantly decreased risk of hip fracture (OR, 0.79 and 0.86, respectively). Patients treated by a neurologist had a significantly lower adjusted likelihood of death (hazard ratio 0.78).

"Women and minorities with PD obtain specialist care less often than white men. Neurologist care of patients with PD may be associated with improved selected clinical outcomes and greater survival," the authors write.

Several authors disclosed financial ties to the pharmaceutical, health care, and biotechnology industries.

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