Research & Publications
Gender, Race, and Socioeconomic Disparities on Surgical Device-Aided Therapies (DATs) Among Medicare Beneficiaries with Advanced Parkinson‚ Disease (APD)
Summary
This study assessed the impact of demographic and clinical characteristics, geographic factors, and social drivers of health on initiation of a surgical device-aided therapy (DAT) among people with advanced Parkinson’s Disease (PwaPD).
Carbidopa-levodopa enteral suspension (CLES) and deep brain stimulation (DBS) are treatment options for PwaPD. While an individual’s preference plays a significant role in choice of treatment, initiation of these surgical DATs may be potentially impacted by health disparities.
Of 112,773 PwaPD patients, only 2.2% started a DAT. Younger individuals (<75 vs 75–84 years) were 2–3x more likely to receive a DAT. Factors associated with a lower likelihood of DAT initiation were female gender, black race, moderate to severe comorbidity, and having lower income status (0.9x, 0.4x, 0.4–0.7x, 0.4x, respectively). In subgroup analyses, individuals who were married (4.1x) or living in a state with a higher number of DAT facilities (1.3x to 1.5x) were more likely to initiate CLES, while individuals completing up to high school education had lower likelihood (0.5x) of CLES initiation versus non-DAT initiation.
Why This Matters
These findings suggest that some health inequities exist for Advanced Parkinson’s Disease patients. Further assessments are encouraged to continue identifying and addressing gender, race, and socioeconomic differences in access and treatment for these patients.
