Association of specialist involvement and quality of care for Parkinson's disease
Identifieur interne : 001110 ( Main/Exploration ); précédent : 001109; suivant : 001111Association of specialist involvement and quality of care for Parkinson's disease
Auteurs : Eric M. Cheng [États-Unis] ; Kari Swarztrauber [États-Unis] ; Andrew D. Siderowf [États-Unis] ; Mahmood S. Eisa [États-Unis] ; Martin Lee [États-Unis] ; Stefanie Vassar [États-Unis] ; Erin Jacob [États-Unis] ; Barbara G. Vickrey [États-Unis]Source :
- 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
Url:
DOI: 10.1002/mds.21311
Affiliations:
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Eisa</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Neurology, Neurosurgery & Spine Clinic of South Georgia, Valdosta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Lee, Martin" sort="Lee, Martin" uniqKey="Lee M" first="Martin" last="Lee">Martin Lee</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Vassar, Stefanie" sort="Vassar, Stefanie" uniqKey="Vassar S" first="Stefanie" last="Vassar">Stefanie Vassar</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Jacob, Erin" sort="Jacob, Erin" uniqKey="Jacob E" first="Erin" last="Jacob">Erin Jacob</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parkinson's Disease Research, Education, and Clinical Center (PADRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Vickrey, Barbara G" sort="Vickrey, Barbara G" uniqKey="Vickrey B" first="Barbara G." last="Vickrey">Barbara G. 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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><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Connecticut</li><li>Géorgie (États-Unis)</li><li>Oregon</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Cheng, Eric M" sort="Cheng, Eric M" uniqKey="Cheng E" first="Eric M." last="Cheng">Eric M. Cheng</name></region><name sortKey="Cheng, Eric M" sort="Cheng, Eric M" uniqKey="Cheng E" first="Eric M." last="Cheng">Eric M. Cheng</name><name sortKey="Eisa, Mahmood S" sort="Eisa, Mahmood S" uniqKey="Eisa M" first="Mahmood S." last="Eisa">Mahmood S. Eisa</name><name sortKey="Eisa, Mahmood S" sort="Eisa, Mahmood S" uniqKey="Eisa M" first="Mahmood S." last="Eisa">Mahmood S. Eisa</name><name sortKey="Jacob, Erin" sort="Jacob, Erin" uniqKey="Jacob E" first="Erin" last="Jacob">Erin Jacob</name><name sortKey="Lee, Martin" sort="Lee, Martin" uniqKey="Lee M" first="Martin" last="Lee">Martin Lee</name><name sortKey="Lee, Martin" sort="Lee, Martin" uniqKey="Lee M" first="Martin" last="Lee">Martin Lee</name><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D." last="Siderowf">Andrew D. Siderowf</name><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D." last="Siderowf">Andrew D. Siderowf</name><name sortKey="Swarztrauber, Kari" sort="Swarztrauber, Kari" uniqKey="Swarztrauber K" first="Kari" last="Swarztrauber">Kari Swarztrauber</name><name sortKey="Vassar, Stefanie" sort="Vassar, Stefanie" uniqKey="Vassar S" first="Stefanie" last="Vassar">Stefanie Vassar</name><name sortKey="Vickrey, Barbara G" sort="Vickrey, Barbara G" uniqKey="Vickrey B" first="Barbara G." last="Vickrey">Barbara G. Vickrey</name><name sortKey="Vickrey, Barbara G" sort="Vickrey, Barbara G" uniqKey="Vickrey B" first="Barbara G." last="Vickrey">Barbara G. Vickrey</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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