Should Primary Care Doctors Refer All Parkinson Disease Cases to Neurologists?

These researchers asked the provocative question of whether involving a neurologist in the care of a patient with Parkinson disease (PD) makes a difference in outcome.

Of almost 139,000 retrospectively identified Medicare beneficiaries with PD seen in 2002, only 68% of patients received neurologist care between 2002 and 2005. Most of the remainder received primary care alone. Compared with patients treated in primary care, neurologist-treated patients had significantly lower 1-year rates of referral to a skilled nursing facility (adjusted odds ratio, 0.79) and of hip fracture (AOR, 0.86) and had significantly lower mortality during 6 years of follow-up (adjusted hazard ratio, 0.78). Women and minorities received neurologist care less often t…