Next time you see your neurologist ask for the research that proves that seeing a neurologist improves clinical outcomes of stroke patients. Not just the death portion but the
100% recovery part also.
Abstract
OBJECTIVE:
To
investigate the utilization of neurologist providers in the treatment
of patients with Parkinson disease (PD) in the United States and
determine whether neurologist treatment is associated with improved
clinical outcomes.
METHODS:
This was a retrospective
observational cohort study of Medicare beneficiaries with PD in the year
2002. Multilevel logistic regression was used to determine which
patient characteristics predicted neurologist care between 2002 and 2005
and compare the age, race, sex, and comorbidity-adjusted annual risk of
skilled nursing facility placement and hip fracture between
neurologist- and primary care physician-treated patients with PD. Cox
proportional hazards models were used to determine the adjusted 6-year
risk of death using incident PD cases, stratified by physician
specialty.
RESULTS:
More than 138,000 incident PD cases
were identified. Only 58% of patients with PD received neurologist care
between 2002 and 2005. Race and sex were significant demographic
predictors of neurologist treatment: women (odds ratio [OR] 0.78, 95%
confidence interval [CI] 0.76-0.80) and nonwhites (OR 0.83, 95% CI
0.79-0.87) were less likely to be treated by a neurologist.
Neurologist-treated patients were less likely to be placed in a skilled
nursing facility (OR 0.79, 95% CI 0.77-0.82) and had a lower risk of hip
fracture (OR 0.86, 95% CI 0.80-0.92) in logistic regression models that
included demographic, clinical, and socioeconomic covariates.
Neurologist-treated patients also had a lower adjusted likelihood of
death (hazard ratio 0.78, 95% CI 0.77-0.79).
CONCLUSIONS:
Women
and minorities with PD obtain specialist care less often than white
men. Neurologist care of patients with PD may be associated with
improved selected clinical outcomes and greater survival.
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