Resource Utilization of Patients with Parkinson's Disease in the Late Stages of the Disease in Germany: Data from the CLaSP Study.

Autor: Kruse C; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany., Kretschmer S; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany.; Department of Neurology, Philipps-University Marburg, Marburg, Germany., Lipinski A; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany.; Department of Neurology, Philipps-University Marburg, Marburg, Germany., Verheyen M; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany., Mengel D; Department of Neurodegenerative Diseases, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany., Balzer-Geldsetzer M; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany.; Department of Neurology, Philipps-University Marburg, Marburg, Germany., Lorenzl S; Department of Neurology, Ludwig-Maximilians University, Munich, Germany.; Krankenhaus Agatharied GmbH, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria., Richinger C; Krankenhaus Agatharied GmbH, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria., Schmotz C; Krankenhaus Agatharied GmbH, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria., Tönges L; Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.; Neurodegeneration Research, Centre for Protein Diagnostics (ProDi), Ruhr-University, Bochum, Germany., Woitalla D; Department of Neurology, St. Josef-Krankenhaus Kupferdreh, Essen, Germany., Klebe S; Department of Neurology, Essen University Hospital, Essen, Germany., Schrag A; Department of Neurology, King's College, London, UK., Dodel R; Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany. richard.dodel@uk-essen.de.; Department of Neurology, Philipps-University Marburg, Marburg, Germany. richard.dodel@uk-essen.de.
Jazyk: angličtina
Zdroj: PharmacoEconomics [Pharmacoeconomics] 2021 May; Vol. 39 (5), pp. 601-615. Date of Electronic Publication: 2021 Mar 19.
DOI: 10.1007/s40273-021-01011-y
Abstrakt: Objective: The Care of Late-Stage Parkinsonism (CLaSP) study aimed to collect qualitative and standardized patient data in six European countries (France, Germany, Netherlands, Portugal, UK, Sweden) to enable a detailed evaluation of the underexplored late stages of the disease (Hoehn and Yahr stage > 3) using clinical, neuropsychological, behavioral, and health economic data. The aim of this substudy was to provide a health economic evaluation for the German healthcare system.
Methods: In Germany, 228 patients were included in the study. Costs were calculated from a societal perspective for a 3-month period. Univariate analyses were performed to identify cost-driving predictors. Total and direct costs were analyzed using a generalized linear model with a γ-distributed dependent variable and log link function. Indirect costs were analyzed using a binomial generalized linear model with probit link function.
Results: The mean costs for the 3-month period were approximately €20,000. Informal care costs and hospitalization are approximately €11,000 and €5000. Direct costs amounted to 89% of the total costs, and the share of indirect costs was 11%. Independent predictors of total costs were the duration of the disease and age. The duration of the disease was the main independent predictor of direct costs, whereas age was an independent predictor of indirect costs.
Discussion: Costs in the late stage of the disease are considerably higher than those found in earlier stages. Compared to the latter, the mean number of days in hospital and the need for care is increasing. Informal caregivers provide most of the care.
Clinical Trial Registration: The protocol was registered at ClinicalTrials.gov as NCT02333175 on 7 January, 2015.
Databáze: MEDLINE
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