Objective: To evaluate referral patterns to a specialist by a primary care provider (PCP) or other healthcare provider (HCP) among people diagnosed with Parkinson’s disease (PD) or a PD-related disorder (PD-RD).

Background: An accurate diagnosis of PD enables timely treatment; however, characteristics of people who are vs are not referred to a specialist are unclear.

Method: This retrospective cohort study analyzed claims data from Optum deidentified Normative Health Information database 1/1/2016–31/12/2021 (study period). Participants (≥18 yo) were required to have ≥2 ICD-9/10-CM diagnosis codes for PD from any provider during the study period. Any PD or PD-RD diagnosis from a PCP or other HCP before or on the date of the PD diagnosis from a specialist (neurologist/neurosurgeon, geriatrician, mental health provider, movement disorder specialist, behavior neurospecialist) was defined as the index event. PD-RD diagnoses were gait abnormality, tremor/abnormal movement, lack of coordination and extrapyramidal diseases. Participants with a PD diagnosis from a specialist comprised the referral cohort. Time to specialist referral was assessed, and characteristics of people who were vs were not referred were summarized.

Results: A total of 26,431 people were included who had a diagnosis of PD or a PD-RD from a PCP or other HCP, among whom 13,911 (53%) were referred to a specialist. The median (IQR) time to first specialist visit was 5.1 (1.6-14.0) mo. Male and White individuals were more likely to be referred vs not referred (54.9% vs 45.1% and 54.8% vs 45.2%, respectively; P<0.001), whereas Hispanic individuals and those ≥75 yo were less likely to be referred vs not referred (44.7% vs 55.3% and 48.2% vs 51.8%, respectively; P<0.001). Regional differences were also observed; people living in the South, Midwest and Northeast were more likely to be referred vs not referred (53.3% vs 46.7%, 62.4% vs 37.6%, 61.8% vs 38.2%, respectively), whereas people living in the West were less likely to be referred vs not referred (40.0% vs 60.0%) (P<0.001 for all).

Conclusion: Approximately half of people diagnosed with PD or a PD-RD by a PCP or other HCP were referred to a specialist, with a median time of 5 mo. Notable differences in sex, age, race and ethnicity and geographic region were observed in people who were vs were not referred.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/referral-patterns-from-primary-care-physicians-to-specialists-among-people-with-parkinsons-disease-or-a-parkinsons-disease-related-disorder/