The coming crisis
Obtaining care for the growing burden of neurodegenerative conditions
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Abstract
As the US population ages, the burden of neurodegenerative disorders, including Alzheimer disease and Parkinson disease, will increase substantially. However, many of these patients and their families currently do not receive neurologic care. For example, a recent study found that over 40% of Medicare beneficiaries with an incident Parkinson disease diagnosis did not receive neurologist care early after diagnosis and those who did not were more likely to fracture a hip, be placed in a nursing home, and die. While geography, age, race, and sex likely contribute to these observed disparities in care and outcomes, a large barrier may be Medicare's reimbursement policies, which value procedures over care. With further reductions in Medicare reimbursement constantly on the horizon, the devaluing of clinical care will likely continue. Rather than guaranteeing access to care, Medicare's reimbursement policies may increasingly be an impediment to care.
GLOSSARY
- PD=
- Parkinson disease
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
Editorial, page 1916
- Received August 15, 2012.
- Accepted in final form January 22, 2013.
- © 2013 American Academy of Neurology
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- Article
- Abstract
- GLOSSARY
- NEUROLOGIC CARE UTILIZATION IS LIMITED
- MEDICARE'S REIMBURSEMENT POLICIES MAY BE CONTRIBUTING TO LOW UTILIZATION AND LIMITED ACCESS
- SUPPLY OF NEUROLOGISTS IS SUFFICIENT TO MEET DEMAND
- THE SOLUTION IS NOT TO PRODUCE MORE NEUROLOGISTS BUT TO INCREASE REIMBURSEMENT FOR PATIENT CARE
- PUBLIC ENGAGEMENT AND LEADERSHIP WILL HAVE TO DRIVE CHANGE
- AUTHOR CONTRIBUTIONS
- STUDY FUNDING
- DISCLOSURE
- ACKNOWLEDGMENT
- Footnotes
- REFERENCES
- Figures & Data
- Info & Disclosures