Objective: There are currently no disease-modifying therapies for persons with Parkinson’s disease (PD), and progressive symptoms contribute to increased risk of hospitalization, particularly in the last 6 months of life. No instruments have been validated in persons with PD to measure the quality of hospital-based care. Using questions from the Quality of Life at the End of Life (QUAL-E) survey modified to capture inpatient care quality in persons with PD, we sought to examine the perceived quality of inpatient care in PD patients who were hospitalized for any reason.

Background: Persons with PD are hospitalized at higher rates, have longer lengths of stay, and are more likely to die in the hospital than age-matched peers. These hospital outcomes are considered markers of poor care quality. In order to improve the quality of hospital-based care, measures of patient care experience must be utilized.

Method: Persons with PD were approached within the first 72 hours of hospitalization in the University of Pennsylvania Health System and completed a modified 20-item QUAL-E survey. Median PD duration was 8 years, and responses were stratified based on longer (≥8 years) or shorter (<8 years) disease duration. Modified survey questions regarding the quality of inpatient care were analyzed using a Chi-square test of proportions.

Results: A total of 30 participants (83% Male, 77% White) completed the survey, 15 (50%) with disease duration ≥8 years and 15 (50%) with disease duration <8 years. Median hospital length of stay (LOS) was longer in those with shorter disease duration (6 days, IQR 4-11) than longer disease duration (2 days, IQR 1-5). However, when asked whether the care they received in the hospital was aligned with their preferences, persons with a shorter disease duration were more likely to agree or strongly agree than persons with a longer disease duration (100% vs. 73%, p=0.03). There were no differences in perceptions of timely medication administration or mobilization.

Conclusion: As disease duration increased, satisfaction with inpatient care decreased despite shorter LOS. These data suggest that hospitalized persons with more advanced PD may benefit from dedicated goals of care discussions regardless of their admission diagnosis. Further research and administration of care quality surveys are needed to elucidate specific ways to improve goal-concordant inpatient care.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-influence-of-parkinsons-disease-duration-on-perceived-quality-of-inpatient-care/