Researchers in Ireland are reporting that people with Parkinson’s disease (PD) are being admitted to hospitals at increasing rates for serious but often preventable conditions — most often, urinary and respiratory tract infections, pneumonia, and fractures of the femur.
The study, “Acute Hospital Admissions of Individuals with a Known Parkinson’s Disease Diagnosis in Ireland 2009-2012: A Short Report,” published in the Journal of Parkinson’s Disease, emphasized the need for interventional care that can help keep patients safely in their own homes for longer.
Using data from the Hospital Inpatient Enquiry (HIPE) system collected between 2009 and 2012, the researchers examined discharge records for 12,437 PD patients over age 65 and 1,223 patients age 65 or younger.
They considered the top 10 main diagnoses at admission, the top 10 procedures conducted, admission sources and routes, as well as final discharge destinations.
Results showed five main reasons for these admission — urinary tract infections, pneumonia, lower respiratory tract infections, aspiration pneumonia (disease due to solid and liquids) and femur fracture. They also found that most admissions were directly to the emergency department (87%), and were steadily rising among the above-65 age group.
Perhaps most troubling, investigators found that, upon discharge, a large portion of PD patients over age 65 required long-term care at a nursing home (27%) — a number that more than doubled in all age categories during the course of the study. In comparison, 12% of patients in this age group were admitted to a hospital from a nursing home.
The study also found that the in-hospital mortality rate for PD patients rose 8%, considerably high than had been previously recorded.
“On a positive note, a lot of the causes of admission to hospital in PD in Ireland are preventable. Currently care delivered is disjointed and it is this fragmented approach that allows individuals to become seriously ill and require hospital admission. Integrated care pathways for community-dwelling adults with chronic neurological diseases, not just PD, should form the bedrock for health and wellness in this population going forward,” Catherine Blake, PhD, co-investigator and researcher at University College Dublin, said in a press release.
Many of the reasons for hospital admissions could be targeted for intervention initiatives, the researchers said, to prevent or treat conditions before they turn serious. Such initiatives would also contribute to reduce stressful and lengthy in-patient stays.
“It is clear from this research that focus and investment is required at primary and community care levels to maintain people with PD in good health and continuing to live in their own homes and communities,” said Olive Lennon, PhD, the study’s lead investigator and researcher at University College Dublin, said.