Healthcare Utilization Patterns of Persons Living with Parkinson's Disease and Related Disorders with Moderate to High Palliative Care Needs

BACKGROUND: Healthcare utilization among individuals with Parkinson's disease and related disorders (PDRD) with significant palliative care (PC) needs is not well characterized. OBJECTIVES: To describe healthcare utilization in a well-defined cohort of PDRD patients with moderate-to-high PC needs. METHODS: We conducted a secondary analysis of a multi-site randomized trial of outpatient PC. Participants reported healthcare utilization every six weeks over 12 months. Outcomes included emergency department (ED) visits, overnight hospitalizations, in-home medical services, and psychosocial or spiritual support. RESULTS: Among 210 patients (mean age 70.1 years; 64% male), the annualized ED visit rate was 1.16 per person-year (95% CI 0.94-1.42) and the hospitalization rate was 0.48 per person-year (95% CI 0.33-0.69). Among 136 participants with complete follow-up, 43.4% had ≥1 ED visit and 21.3% had ≥1 hospitalization. Home-based services were used by 38.1%. CONCLUSIONS: Utilization rates exceeded those reported in broader PD populations but were lower than in dementia. Persistent home-based care needs highlight ongoing supportive care demands.