More than 15,000 (Ministry of Health, 2019/20) British Columbians live with Parkinson’s Disease (PD); our aging population means this number will only increase. While treatment is complex, it is one of the most treatable neurological conditions. With expert and appropriate treatment and therapies, disease progression can be managed with decreased risk of falls, hospitalizations and referrals to long term care. Many patients who are well managed are able to live independently for many years.
While expert supports are available in the province, long waitlists often lead to delayed treatment and unnecessary disease progression. Once patients do receive care, allied health professionals often lack knowledge of PD and best practices for disease management, leading patients to often receive improper treatment in emergency rooms, hospitals, general practices, and care homes. And patients with advanced Parkinson’s have limited therapeutic options so that often the only option is placement in expensive complex care facilities.
1. Add specialized staff to existing PD programs
- Add physicians and allied health professionals to allow additional and timely assessment capacity at PD specific treatment programs in the province. Patients currently can face an 18- 24 month wait during which their condition continues to deteriorate.
2. Fund PD specific training for allied health professionals
- People living with PD regularly use physio services to maintain movement but very few of the province’s 3,500 physiotherapists have training related to PD and movement disorders.
- The situation is similar for other allied health professionals such as speech language pathologists and occupational therapists.
3. Expand the Deep Brain Stimulation program
- This is an option for a small number of patients with advanced PD. The surgery has enabled people to live independently in their own homes for many more years.
- However, patients can wait up to five years for surgery, given funding limits. As PD is progressive, patients may no longer fit the criteria for surgery after waiting so long.
4. Expand medication coverage
- Access to appropriate medications can help keep people with PD independent, assisting with activities of daily living that most of us take for granted such as mobility and the ability to speak and swallow. The alternative is grim: increased risk of falls, being confined to bed, reduced communication and increased risk of choking.
- In a June 2017 PSBC survey with 400 respondents, 17% reported either sometimes or always having difficulty with paying out of pocket costs for medication.
5. Support for Carepartners
- Results from the PSBC survey indicate that the majority of Care Partners of people with PD were spouses, female, retired and lived with the person they cared for. 28% indicated responsibilities of caregiving affected emotions such as anger, resentment, depression and anxiety which had a negative impact on quality of life and a loss of freedom.
- Failing health of the care partner usually results in the person with PD transitioning to residential sooner than necessary and/or more frequent use of emergency services and acute care.
- Providing support such as home care and respite can make a difference in the care partner’s ability to continue to care for the person with PD. By taking action in these areas the province can help those with PD lead independent lives as long as possible and reduce their overall impact on the healthcare system.
Expected Benefits
- A cost avoidance of a conservative $4 million (based on an average cost of $80,000 per LTC bed x 50 people per year. Cost for a hospital bed is $400 to$1100 or $33,000 per day).
- Payback through controlling costs:
- Research shows that Parkinson’s patient outcomes improve with regular access to specialized care.
- Admissions to hospital and long term care are reduced.
- Parkinson’s disease (PD) is the second most common neurological disease after Alzheimer’s.
- Parkinson’s has the third highest level of direct health care costs for neurological disease, after Alzheimer’s disease and Epilepsy.
- In 2012/2013, the BC Ministry of Health estimated that $112 million was spent on direct care related to PD including hospital, MSP, and Pharmacare costs. The estimated cost in 2000-2001 was $45 million.
- BC’s Ministry of Health data indicates the number of Parkinson’s patients in BC has increased by 39% in the last decade from around 8,600 in 2001-02 to 13,300 in 2013-14.
- The number of people with PD is expected to roughly double by 2031; as a result, costs can be projected to double to $224 million by 2031.