Sociodemographic differences in skilled nursing facility discharge among Parkinson’s disease related healthcare utilizers

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that often results in increased healthcare utilization and long-term care needs. While national trends have highlighted differences in institutional care utilization, limited research has examined factors associated with discharge to skilled nursing facilities (SNF) among PD healthcare utilizers in Nevada. We conducted a retrospective analysis of PD-related healthcare utilization records from the Nevada Center for Health Information Analysis (CHIA) between 2013 and 2021 (N = 64,088). Parkinson’s disease and parkinsonism were identified using ICD-9 and ICD-10 codes in any diagnosis position. The primary outcome was discharge to an SNF. Bivariate analyses and multivariable logistic regression models were used to examine associations between SNF discharge and demographic, temporal, geographic, and utilization-related factors. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. Overall, 13.2% of PD-related healthcare encounters resulted in discharge to an SNF. In adjusted analyses, older age was associated with higher odds of SNF discharge (aOR = 1.027 per year; 95% CI: 1.025–1.030; p < 0.001). Inpatient admissions were strongly associated with SNF discharge compared with outpatient encounters (aOR = 5.934; 95% CI: 5.493–6.410; p < 0.001). Compared with White healthcare utilizers, Black (aOR = 1.599; 95% CI: 1.457–1.756; p < 0.001) and Native American or Alaskan Native individuals (aOR = 2.389; 95% CI: 1.864–3.062; p < 0.001) had significantly higher odds of SNF discharge. Residents of rural (aOR = 0.477; 95% CI: 0.424–0.536) and frontier areas (aOR = 0.547; 95% CI: 0.491–0.608) were less likely to be discharged to an SNF compared with urban residents (both p < 0.001). This study highlights demographic differences in discharge to an SNF among PD healthcare utilizers in Nevada. Findings underscore the need to address differences in long-term care access options and promote alternative discharge settings especially among racial and ethnic minority communities. Ensuring access to personalized care options could help to improve quality of life and provide support for people with PD. • More than 13% of Parkinson’s disease healthcare utilizers in Nevada were discharge to skilled nursing facilities (SNFs) • Older age, inpatient admission, and urban residence significantly increased likelihood of SNF discharge • Black and Native American/Alaskan Native patients had higher odds of SNF discharge compared to White patients • Highlight the need for improved access to alternative long-term care options and personalized care