Association of specialist involvement and quality of care for Parkinson's disease

Eric M. Cheng, Kari Swarztrauber, Andrew D. Siderowf, Mahmood S. Eisa, Martin Lee, Stefanie Vassar, Erin Jacob, Barbara G. Vickrey

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement-disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing-off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nonmotor PD symptoms.

Original languageEnglish (US)
Pages (from-to)515-522
Number of pages8
JournalMovement Disorders
Issue number4
StatePublished - Mar 15 2007
Externally publishedYes


  • Indicators
  • Movement-disorder specialist
  • Parkinson's disease
  • Quality of care

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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