3075 — Patient and Organizational Factors Related to Education and Support Use by Veterans with Parkinson’s Disease

Pogoda TK (Center for Organization, Leadership and Management Research (COLMR), Boston, MA), Cramer IE (COLMR), Meterko M (COLMR), Lin H (COLMR), Hendricks A (Health Care Financing & Economics), Holloway R (University of Rochester School of Medicine and Dentistry), Nealon Seibert M (COLMR), Stolzmann K (COLMR), Ballah KG (COLMR), Charns MP (COLMR)

Objectives:
In 2001, the VA established six Parkinson’s Disease Research, Education, and Clinical Centers (PADRECCs) to provide multidisciplinary care, conduct research, and offer education and support services (ESS). We analyzed Parkinson’s disease (PD) patient and organizational characteristics related to ESS utilization, hypothesizing that, compared to patients at other VA medical centers (VAMC), patients at PADRECC VAMCs would be more likely to utilize ESS due to the specialization and mission of the PADRECCs.

Methods:
A stratified random sample of PD patients were identified from VA administrative data and mailed screener letters (n = 6693). Those who confirmed their PD diagnosis and provided informed consent were mailed a questionnaire including sections regarding demographic/individual characteristics, general and PD-related health status/function, and ESS utilization (i.e. types of information received, methods of receiving information, reasons for non-participation, non-VA resource utilization, satisfaction, and intent regarding future VA utilization).

Results:
A total of 2330 (83%) completed surveys were returned by patients from VAMCs with (n = 882) and without (n = 1448) PADRECCs. Altogether, 15.8% (n = 354) of patients utilized ESS. PADRECC VAMC patients were generally healthier and more educated than other VAMC patients. After statistically controlling for these differences, being a PADRECC VAMC patient and using only VA providers (as compared to a combination of VA and non-VA providers) were significant predictors of ESS utilization. Further, proportionally more of the PADRECC VAMC patients reported receiving the broad range of ESS and higher satisfaction with these services than did patients at other VAMCs.

Implications:
PD patients receiving care at PADRECC VAMCs were more likely to receive ESS for a broad array of issues utilizing a variety of delivery modalities than PD patients at VAMCs without a PADRECC. Further research is needed to determine whether these differences are driven by variation in program availability, outreach efforts, or other factors.

Impacts:
There is strong support in the literature for the importance of ESS for patients with chronic disease. This study provides preliminary evidence that organizing care by multidisciplinary specialized centers, as exemplified by the PADRECCs, is associated with a positive effect on provision of ESS.