Objective: Describe discrepancies on survival and access to DBS in PD in Colombia by gender and affiliation regime.
Background: Lower socioeconomic status (SES) has been linked with higher mortality and lower access to treatments, such as deep-brain stimulation (DBS). These variables can be studied in Colombia with SISPRO, the official healthcare registry, which covers 99% of the population. Access to health-system is granted mainly through two insurance schemes: contributory, for people above certain income thresholds, or subsidized, for low-income population. Subsidized scheme can therefore be a proxy to study low SES.
Method: People over 40 years-old diagnosed with PD registered between January 2017 and December 2021 were characterised according to insurance-scheme. Survival was estimated calculating people on a year-by-year basis. A cessation of consultation for over two years was assumed as death. Procedures categorised as “neurostimulator implantation” or “thalamus or basal ganglia procedures” in patients with PD are described. Costs of DBS were calculated by dividing the total cost by the number of patients with the procedure.
Results: Overall survival was 49.7% after 5 years. Women on the contributory-scheme survived 8.9% more than on the subsidized-scheme (48.8% vs 39.9%). Men on the contributory-scheme survived 10.2% more than the subsidized-scheme (52.9% vs 42.7%). A total of 196 DBS were implanted, most of them in Bogotá (54%) and on men (45.4%) and on women (27%) from the contributory-scheme (45.4%), compared to men (15.8%) and women (11.7%) from the subsidized-scheme. Total expenditure on DBS implantation was reported on 23,220 USD.
Conclusion: When using insurance schemes as proxies for SES, a lower survival rate is associated with the subsidized-regime for both women and men. Access to DBS implantation is also different when comparing regimes. Further research is necessary in order to broaden information about the impact of SES on treatment and progression of PD.
To cite this abstract in AMA style:C. Pantoja-Ruiz, D. Rosselli. Social and gender inequity on overall survival and access to deep brain stimulation in Parkinson disease patients in Colombia [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/social-and-gender-inequity-on-overall-survival-and-access-to-deep-brain-stimulation-in-parkinson-disease-patients-in-colombia/. Accessed September 27, 2023.
« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/social-and-gender-inequity-on-overall-survival-and-access-to-deep-brain-stimulation-in-parkinson-disease-patients-in-colombia/