Abstract
There are racial and socioeconomic disparities in the care of patients with Parkinson’s disease (PD). Bellevue Hospital Center (BHC) in New York City is the oldest public hospital in the United States providing care to a multiracial, socioeconomically diverse and medically underserved population. We investigated racial and social disparities in providing care to patients with PD and related disorders at BHC compared to a NYU Langone Health, a Parkinson’s Foundation Center of Excellence. Retrospective chart review of patients with diagnosis of PD or PD-related disorders evaluated at BHC or at NYU outpatient clinics from January 2012 to August 2017. 100 patients were enrolled from each site: BHC (55% men); NYU (49% men). The majority of patients at NYU were White (77%), compared to 14% at BHC; Hispanic patients comprised the majority at BHC (56%) (p < 0.001). BHC patients had more clinic visits per year compared to the NYU cohort (2.88 vs. 2.40, p = 0.001). BHC patients were less likely to self-report exercise (p = 0.047) or participation in physical therapy (p = 0.015). There were no clinically significant differences in diagnosis type, time to diagnosis, average Hoehn & Yahr or levodopa equivalent dose. Compared to a Parkinson’s Foundation Center of Excellence, PD patients in a public hospital system are more racially diverse, are less likely to be insured, have higher rates of care utilization and are less likely to access necessary interventions such as physical therapy and exercise.
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Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. We would like to thank the clinicians of Bellevue Hospital Center who every day, strive to provide quality care to low-income patients, despite limited resources. And thank you to the patients of Bellevue Hospital Center who have contributed to the education of many physicians worldwide.
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L.N. was involved in developing the concept, design of the study, project organization, data acquisition, analysis and interpretation of data, literature search, and drafting and revision of the manuscript. J.A. participated in data acquisition, statistical analysis, and revision and critique of the manuscript. R.G. was involved in conception and design of the study, project organization, data collection, analysis and interpretation of data, and revision and critique of the manuscript.
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Nwabuobi, L., Agee, J. & Gilbert, R. Racial and Social Disparities in Health and Health Care Delivery among Patients with Parkinson’s Disease and Related Disorders in a Multiracial Clinical Setting. J Cross Cult Gerontol 36, 253–263 (2021). https://doi.org/10.1007/s10823-021-09436-w
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DOI: https://doi.org/10.1007/s10823-021-09436-w