An investigation into the diagnoses, treatment, and hospital commutes in patients with advanced–stage Parkinson's disease

Abstract

We aimed to investigate the conditions of medical treatment in patients with advanced–stage Parkinson's disease. We carried out a retrospective survey of the symptoms, content of treatments, circumstances of hospital commutes, and the social systems utilized by 113 patients, all of whom received a score of 4 or 5 on the Hoehn & Yahr clinical severity classification, and had been receiving medical treatment at this hospital for the past 4 years. As movement is extremely difficult for patients who are in an advanced stage of a serious illness such as Parkinson's disease, traveling to the hospital can cause them severe distress. However, outpatient treatments and the accompanying medical treatment system have not yet been established enough at this hospital. Moreover, people acquiring nursing care authorizations whom received a score of 4 on the Hoehn & Yahr clinical severity classification was 70.0% and whom recognized as a score of 5 on the same classification was 88.2%. In comparison to this fact, the number of patients receiving physical disability certificates is low, such as, 37.6% for patients whom received a score of 4 on the Hoehn & Yahr clinical severity classification and 66.7% for patients recognized as a score of 5 on the same classification. For these reasons, we thought it necessary to understand how patients utilize social resources for their commutes to the hospital. A high ratio of patients had recently received operative treatment, leading us to consider the possibility that they were already visiting specialists at the university hospital for post–operative care. In order to improve the environment in which patients with advanced–stage Parkinson's undergo medical treatment, we think it is necessary to identify some of the problems.