Exactly why the USA need a NHS...!

Nic 57/15


On Thu, Oct 8, 2009 at 6:25 PM, mschild <[log in to unmask]> wrote:

>
>
> Black Americans newly diagnosed with Parkinson's disease are a quarter as
> likely as whites to walk out of their first office visit with a
> prescription for
> anti-PD treatment, according to a new study.
>
> Researchers identified new diagnoses of PD from Medicaid records in
> Pennsylvania between 1999 and 2003, excluding patients with possible
> secondary
> parkinsonism, as well as those who received anti-PD treatments in the prior
> 12
> months. Of the 307 identified cases, 264 were white and 43 were black.
> Compared
> to historical averages for all PD patients, patients in this study were
> somewhat younger (mean age 55) and more likely to be female (61%), but
> there
> were no significant differences in these variables between blacks and
> whites.
> The initial visit was with a neurologist for 33% of blacks and 39% of
> whites
> (difference not significant); about 90% of both groups were eligible for
> Medicaid because of a disability; and blacks were more likely to receive
> care
> in an urban setting compared to whites (p<0.0001).
>
> Thirty-four percent of patients received a prescription for anti-PD
> medication
> or physical therapy at their first office visit, but the rates differed by
> race:
> 12% of blacks and 38% of whites received prescriptions. The odds ratio for
> receiving a prescription was 0.24 (95% confidence interval 0.09-0.64) for
> blacks. The two groups had about equal rates of six-month follow-up
> appointments.
>
> The authors point out that the sample was relatively young, poor, and
> disabled, and that "multiple comorbid conditions that require treatment may
> discourage clinicians from adding therapies with potential cross-
> interactions," potentially affecting the generalizability of the results to
> the
> larger population.
>
> "Our data cannot explain whether differences in treatment were due to
> differences in provider recommendations or differences in patient
> acceptance of
> treatment," the authors note. "Understanding the underlying causal
> mechanisms
> of these racial disparities such as patient and physician preferences,
> patient-physician communication, and confounding socioeconomic differences
> is
> important to develop interventions to reduce inequities in care and improve
> health for all patients with PD."
>
> Treatment disparities in Parkinson's disease
> N Dahodwala, M Xie, E Noll, A Siderowf, DS Mandell
> Ann Neurol 2009;66:142-145
>
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