Association of specialist involvement and quality of care for Parkinson's disease
Identifieur interne : 002470 ( Main/Corpus ); précédent : 002469; suivant : 002471Association of specialist involvement and quality of care for Parkinson's disease
Auteurs : Eric M. Cheng ; Kari Swarztrauber ; Andrew D. Siderowf ; Mahmood S. Eisa ; Martin Lee ; Stefanie Vassar ; Erin Jacob ; Barbara G. VickreySource :
- Movement Disorders [ 0885-3185 ] ; 2007-03-15.
English descriptors
Abstract
Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society
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DOI: 10.1002/mds.21311
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ISTEX:F92C89C542D8464723FFC2B225022F7EF647FC63Le document en format XML
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Cheng</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University of California, Los Angeles, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Swarztrauber, Kari" sort="Swarztrauber, Kari" uniqKey="Swarztrauber K" first="Kari" last="Swarztrauber">Kari Swarztrauber</name><affiliation><mods:affiliation>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</mods:affiliation></affiliation></author><author><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D." last="Siderowf">Andrew D. 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Cheng</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University of California, Los Angeles, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Swarztrauber, Kari" sort="Swarztrauber, Kari" uniqKey="Swarztrauber K" first="Kari" last="Swarztrauber">Kari Swarztrauber</name><affiliation><mods:affiliation>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</mods:affiliation></affiliation></author><author><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D." last="Siderowf">Andrew D. 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Eisa</name><affiliation><mods:affiliation>Department of Neurology, Yale University, New Haven, Connecticut, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia, USA</mods:affiliation></affiliation></author><author><name sortKey="Lee, Martin" sort="Lee, Martin" uniqKey="Lee M" first="Martin" last="Lee">Martin Lee</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Vassar, Stefanie" sort="Vassar, Stefanie" uniqKey="Vassar S" first="Stefanie" last="Vassar">Stefanie Vassar</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Jacob, Erin" sort="Jacob, Erin" uniqKey="Jacob E" first="Erin" last="Jacob">Erin Jacob</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Vickrey, Barbara G" sort="Vickrey, Barbara G" uniqKey="Vickrey B" first="Barbara G." last="Vickrey">Barbara G. Vickrey</name><affiliation><mods:affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University of California, Los Angeles, California, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2007-03-15">2007-03-15</date><biblScope unit="volume">22</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="515">515</biblScope><biblScope unit="page" to="522">522</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">F92C89C542D8464723FFC2B225022F7EF647FC63</idno><idno type="DOI">10.1002/mds.21311</idno><idno type="ArticleID">MDS21311</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>indicators</term><term>movement‐disorder specialist</term><term>quality of care</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Eric M. Cheng MD, MS</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string><json:string>Department of Neurology, University of California, Los Angeles, California, USA</json:string></affiliations></json:item><json:item><name>Kari Swarztrauber MD, MPH</name><affiliations><json:string>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</json:string></affiliations></json:item><json:item><name>Andrew D. Siderowf MD, MSCE</name><affiliations><json:string>PADRECC, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA</json:string><json:string>Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA</json:string></affiliations></json:item><json:item><name>Mahmood S. Eisa MD</name><affiliations><json:string>Department of Neurology, Yale University, New Haven, Connecticut, USA</json:string><json:string>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia, USA</json:string></affiliations></json:item><json:item><name>Martin Lee PhD</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string><json:string>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string></affiliations></json:item><json:item><name>Stefanie Vassar MS</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string></affiliations></json:item><json:item><name>Erin Jacob BA</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string></affiliations></json:item><json:item><name>Barbara G. Vickrey MD, MPH</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</json:string><json:string>Department of Neurology, University of California, Los Angeles, California, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>quality of care</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>indicators</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>movement‐disorder specialist</value></json:item></subject><articleId><json:string>MDS21311</json:string></articleId><language><json:string>eng</json:string></language><abstract>Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P > 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society</abstract><qualityIndicators><score>7.025</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1394</abstractCharCount><pdfWordCount>4613</pdfWordCount><pdfCharCount>30484</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>201</abstractWordCount></qualityIndicators><title>Association of specialist involvement and quality of care for Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>22</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>8</total><last>522</last><first>515</first></pages><issn><json:string>0885-3185</json:string></issn><issue>4</issue><subject><json:item><value>Research 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uri="https://api.istex.fr/document/F92C89C542D8464723FFC2B225022F7EF647FC63/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Association of specialist involvement and quality of care for Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2007</date></publicationStmt><notesStmt><note type="content">*The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.</note><note>Veteran's Administration and the VA Parkinson's Disease, Education, Research, and Clinical Centers (PADRECC)</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Association of specialist involvement and quality of care for Parkinson's disease</title><author><persName><forename type="first">Eric M.</forename><surname>Cheng</surname></persName><roleName type="degree">MD, MS</roleName><note type="correspondence"><p>Correspondence: VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, B500, ML 127, Dept. of Neurology, Los Angeles, CA 90073</p></note><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>Department of Neurology, University of California, Los Angeles, California, USA</affiliation></author><author><persName><forename type="first">Kari</forename><surname>Swarztrauber</surname></persName><roleName type="degree">MD, MPH</roleName><affiliation>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</affiliation></author><author><persName><forename type="first">Andrew D.</forename><surname>Siderowf</surname></persName><roleName type="degree">MD, MSCE</roleName><affiliation>PADRECC, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA</affiliation><affiliation>Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA</affiliation></author><author><persName><forename type="first">Mahmood S.</forename><surname>Eisa</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Yale University, New Haven, Connecticut, USA</affiliation><affiliation>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia, USA</affiliation></author><author><persName><forename type="first">Martin</forename><surname>Lee</surname></persName><roleName type="degree">PhD</roleName><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation></author><author><persName><forename type="first">Stefanie</forename><surname>Vassar</surname></persName><roleName type="degree">MS</roleName><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation></author><author><persName><forename type="first">Erin</forename><surname>Jacob</surname></persName><roleName type="degree">BA</roleName><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation></author><author><persName><forename type="first">Barbara G.</forename><surname>Vickrey</surname></persName><roleName type="degree">MD, MPH</roleName><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>Department of 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We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>quality of care</term></item><item><term>indicators</term></item><item><term>movement‐disorder specialist</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-06-23">Received</change><change when="2006-09-25">Registration</change><change when="2007-03-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/F92C89C542D8464723FFC2B225022F7EF647FC63/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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type="manuscriptAccepted" date="2006-09-25"></event><event type="firstOnline" date="2007-01-26"></event><event type="publishedOnlineFinalForm" date="2007-03-27"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2007-01-26"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.4.7 mode:FullText source:FullText result:FullText" date="2011-02-24"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">515</numbering><numbering type="pageLast">522</numbering></numberingGroup><correspondenceTo>VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, B500, ML 127, Dept. of Neurology, Los Angeles, CA 90073</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS21311.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="26"></count><count type="wordTotal" number="5274"></count></countGroup><titleGroup><title type="main" xml:lang="en">Association of specialist involvement and quality of care for Parkinson's disease<link href="#fn1"></link></title><title type="short" xml:lang="en">Quality of PD Care by Specialty of Provider</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Eric M.</givenNames><familyName>Cheng</familyName><degrees>MD, MS</degrees></personName><contactDetails><email>Eric.Cheng@va.gov</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Kari</givenNames><familyName>Swarztrauber</familyName><degrees>MD, MPH</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af4 #af5"><personName><givenNames>Andrew D.</givenNames><familyName>Siderowf</familyName><degrees>MD, MSCE</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af6 #af7"><personName><givenNames>Mahmood S.</givenNames><familyName>Eisa</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af8"><personName><givenNames>Martin</givenNames><familyName>Lee</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Stefanie</givenNames><familyName>Vassar</familyName><degrees>MS</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Erin</givenNames><familyName>Jacob</familyName><degrees>BA</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Barbara G.</givenNames><familyName>Vickrey</familyName><degrees>MD, MPH</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, University of California, Los Angeles, California, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>PADRECC, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, Yale University, New Haven, Connecticut, USA</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="US" type="organization"><unparsedAffiliation>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia, USA</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="US" type="organization"><unparsedAffiliation>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">quality of care</keyword><keyword xml:id="kwd3">indicators</keyword><keyword xml:id="kwd4">movement‐disorder specialist</keyword></keywordGroup><fundingInfo><fundingAgency>Veteran's Administration and the VA Parkinson's Disease, Education, Research, and Clinical Centers (PADRECC)</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, <i>P</i> = 0.006) and nonneurologist involvement (52%, <i>P</i> < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Association of specialist involvement and quality of care for Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Quality of PD Care by Specialty of Provider</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Association of specialist involvement and quality of care for Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Eric M.</namePart><namePart type="family">Cheng</namePart><namePart type="termsOfAddress">MD, MS</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>Department of Neurology, University of California, Los Angeles, California, USA</affiliation><description>Correspondence: VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, B500, ML 127, Dept. of Neurology, Los Angeles, CA 90073</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kari</namePart><namePart type="family">Swarztrauber</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Providence Medical Group, Providence Health System, Newberg, Oregon, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew D.</namePart><namePart type="family">Siderowf</namePart><namePart type="termsOfAddress">MD, MSCE</namePart><affiliation>PADRECC, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA</affiliation><affiliation>Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mahmood S.</namePart><namePart type="family">Eisa</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Yale University, New Haven, Connecticut, USA</affiliation><affiliation>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin</namePart><namePart type="family">Lee</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefanie</namePart><namePart type="family">Vassar</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Erin</namePart><namePart type="family">Jacob</namePart><namePart type="termsOfAddress">BA</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Barbara G.</namePart><namePart type="family">Vickrey</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA</affiliation><affiliation>Department of Neurology, University of California, Los Angeles, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2007-03-15</dateIssued><dateCaptured encoding="w3cdtf">2006-06-23</dateCaptured><dateValid encoding="w3cdtf">2006-09-25</dateValid><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">26</extent><extent unit="words">5274</extent></physicalDescription><abstract lang="en">Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement‐disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing‐off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms. © 2007 Movement Disorder Society</abstract><note type="content">*The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.</note><note type="funding">Veteran's Administration and the VA Parkinson's Disease, Education, Research, and Clinical Centers (PADRECC)</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>quality of care</topic><topic>indicators</topic><topic>movement‐disorder specialist</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>22</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>515</start><end>522</end><total>8</total></extent></part></relatedItem><identifier type="istex">F92C89C542D8464723FFC2B225022F7EF647FC63</identifier><identifier type="DOI">10.1002/mds.21311</identifier><identifier type="ArticleID">MDS21311</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2007 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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