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Sex-Specific Patient Journeys in Early Parkinsons Disease in the Netherlands

机译:荷兰早期帕金森氏病的特定性别患者旅程

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摘要

>Objective: To reconstruct a sex-specific patient journey for Dutch persons with Parkinson's disease (PD) during the first 5 years after diagnosis.>Method: We analyzed a national administrative medical claims database containing data of all patients newly diagnosed with PD between 2012 and 2016 in the Netherlands. We performed time-to-event analysis to identify the moments when patients received care from neurologists, allied healthcare therapists or general practitioners. We also extracted relevant clinical milestones: unexpected hospitalization for PD, pneumonia, orthopedic injuries, nursing home admission, and death. Using these data, we constructed the patient journey stratified for sex.>Results: We included claims data of 13,518 men and 8,775 women with newly diagnosed PD in the Netherlands. While we found little difference in neurologist consultations, women visited general practitioners and physiotherapists significantly earlier and more often (all p-values < 0.001). After 5 years, 37.9% (n = 3,326) of women had visited an occupational therapist and 18.5% (n = 1,623) a speech and language therapist at least once. This was 33.1% (n = 4,474) and 23.7% (n = 3,204) for men. Approximately 2 years after diagnosis, PD-related complications (pneumonia, orthopedic injuries, and PD-related hospitalization) occurred for the first time (women: 1.8 years; men: 2.3 years), and after 5 years, 72.9% (n = 6,397) of women, and 68.7% (n = 9,287) of men had experienced at least one.>Discussion: Considering the strengths and limitations of our methods, our findings suggest that women experience complications and access most healthcare services sooner after diagnosis and more frequently than men. The identified sex differences extend the debate about phenotypical differences in PD between men and women.
机译:>目的:在诊断后的前5年中为荷兰帕金森氏病(PD)患者重建针对性别的患者旅程。>方法:我们分析了国家行政医疗要求该数据库包含荷兰2012年至2016年之间所有新诊断为PD的患者的数据。我们进行了事件发生时间分析,以确定患者从神经科医生,专职医疗保健治疗师或全科医生那里接受护理的时刻。我们还提取了相关的临床里程碑:PD意外住院,肺炎,骨科损伤,疗养院入院和死亡。使用这些数据,我们构建了按性别分层的患者旅程。>结果:我们纳入了荷兰的13518名男性和8,775名女性新诊断为PD的索赔数据。虽然我们在神经科医生的会诊中几乎没有差异,但女性明显更早且更频繁地拜访了全科医生和理疗师(所有p值<0.001)。 5年后,至少有一次拜访过职业治疗师的女性占37.9%(n = 3,326),而语言和语言治疗师的女性占18.5%(n = 1,623)。男性分别为33.1%(n = 4,474)和23.7%(n = 3,204)。诊断后约2年,首次发生PD相关并发症(肺炎,骨科损伤和PD相关住院),女性(1.8岁;男性:2.3岁)首次出现; 5年后,发生72.9%(n = 6,397) )的女性,至少有68.7%(n = 9,287)的男性经历过至少一种。>讨论:考虑到我们方法的优势和局限性,我们的发现表明女性经历了并发症并获得了大多数医疗服务诊断后更快,比男性更常见。所发现的性别差异扩大了关于男女PD的表型差异的争论。

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