Background Little is known about the perceived care situation of patients with Morbus Parkinson's disease in Germany. Specifically, there is a growing interest in health services research to improve the understanding of the role of different actors in the care process across disease progression, potential differences between care structures/regions and patient satisfaction within the individual care situation. Methods In 2016, a cross-sectional survey was conducted, and data were collected from 1,273 members of the German Parkinson's Disease Association (dPV). The self-administered questionnaire included, among other topics, the dispensation of medical care and concomitant therapies. Descriptive and inferential statistical evaluations of these 2 dimensions are part of the present work. Results According to the interviewees, the final diagnosis of Parkinson's disease was made by neurologists/psychiatrists in 61.0% (n=787) and by a neurological clinic in 17.4% (n=222). In this regard, 50.0% of respondents said it had taken a year or more after perceiving initial symptoms associated with Parkinson's disease before they received the diagnosis. Drug therapy was subsequently initiated in 90.1% (n=1,089) by neurologists/psychiatrists. Prior to diagnosis, due to initial symptoms associated with Parkinson's disease patients consulted, at least once (with the possibility of multiple responses), a general practitioner (69.0%, n=878), a neurologist/psychiatrist (37.6%, n=436), an orthopaedist (29.4%, n=374) and/or an internist (23.9%, n=304). The proportion of diagnoses by general practitioners and internists in rural regions was significantly higher than in urban regions (χ2 (3, n=1.063)=8,521; p=0,036). The initiation of therapy by general practitioners and internists was more than twice as likely to happen in rural areas in comparison to urban regions (OR: 2.16, 95%-CI: 1.36-3.44, p=0.001, adjusted for gender and age). In addition, in the case of Parkinson's disease diagnosed by the general practitioner/therapist, therapy initiation occurred significantly later (χ2 (3, n=799)=13,094; p=0.004). As concomitant therapy, patients most commonly received physiotherapy (85.0%, n=1,032); followed by patients who received speech therapy (30.4%, n=284) and occupational therapy (27.4%, n=246). The perception of satisfaction diverged between medical care and concomitant therapy (scale: 0=not at all satisfied to 5=very satisfied). For satisfaction with the number of visits to the doctor, the mean was 4.4 (SD: ±1.3). The average assessment of the received concomitant therapy (scale: 0=not at all sufficient to 5=absolutely sufficient) for occupational therapy was 2.3 (SD: ±2.0), for speech therapy 2.4 (SD: ±2.0) and for physiotherapy 3.0 (SD: ±1.7). Conclusion The results show that in the prediagnostic phase Parkinson's patients from the dPV group had consulted various specialist groups such as general practitioners, orthopaedists and internists, while diagnosis and treatment initiation was ostensibly located among neurologists/psychiatrists. Regional disparities in the care structure are not reflected in the results and are limited to a proportionately greater role for general practitioners and internists in rural areas. Across regions, concomitant therapies do not appear to be appropriately integrated into patient care for adequate satisfaction.
|Translated title of the contribution||Patients' Perspective on Provided Health Services in Parkinson's Disease in Germany - A Cross-Sectional Survey|
|Number of pages||11|
|Publication status||Published - 9 Jul 2018|
- cross-sectional questionnaire
- health services research
- Parkinson's disease
- patients' perspective