Socioeconomic Disparities in Aspiration Pneumonia Hospitalizations in Parkinson’s Disease Patients
Shrey Patel1, Jason Margolesky2
1HCA Kendall Hospital Transitional Year Program, 2University of Miami School of Medicine
Objective:

We analyzed Parkinson’s disease (PD) hospitalizations for aspiration pneumonia by utilizing a nationally representative database.

Background:

PD is a progressive neurodegenerative disorder with motor and nonmotor manifestations, including dysphagia. Aspiration pneumonia is a common cause of mortality in PD patients. Few studies offer insight into the epidemiologic characterization of aspiration pneumonia hospitalizations within PD patients.

Design/Methods:

We reviewed the National Inpatient Sample from the years 2016 to 2020. We identified patients hospitalized for aspiration pneumonia/pneumonitis using the Clinical Classifications Software Refined (CCSR) database (CCSR code: RSP010). PD patients were identified using ICD-10-CM code G20. Age, sex, race, income, and insurance status, information was collected from each hospitalization. Multivariable logistic and linear regression models were applied to the sample to identify key differences in each of these variables by evaluating for outcomes of cost, length of stay, and mortality.

Results:

We sampled 45,515 individuals with an average age of 79.6, predominantly male (70.2%), and Medicare recipients (91.0%). Notably, patients that were self-pay/no charge/other had significantly higher mortality than patients with private insurance (p<0.001). Black patients and Medicaid patients exhibited longer lengths of stay (p<0.001) and cost of care (p<0.001). Hispanic (p<0.001) and Asian (p<0.001) patients also experienced higher cost of care, however, Asian patients experienced shorter lengths of stay (p=0.015).

Conclusions:

Our findings add to the literature analyzing aspiration pneumonia in PD patients, highlighting possible socioeconomic differences in outcomes among hospitalized patients. Although we provided a strong analysis of a large sample, several limitations exist. Since hospitalizations were identified using ICD-10-CM codes, the accuracy of the aspiration pneumonia diagnosis compared to other types of pneumonia can be scrutinized. Additionally, many patients who may have had PD may not have been diagnosed, and thus excluded. Our findings from this study characterizes these socioeconomic differences and calls for further investigation.

10.1212/WNL.0000000000210733
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