Costs and efficacy of a short-stay concept intervention in end phase Parkinson's disease. A comparison between 'regular' care and a short-stay concept.

There are currently several causes of Parkinson's disease known fact: heredity,
poisoning, infection and aging. The cause of the largest group of Parkinson
patients is unknown (idiopathic). The idiopathic form probably plays a limited
role in heredity. A genetically determined, inborn vulnerability combined with
exposure to environmental factors could be contributing factors. It is thought
that these or other causes the cells of the substantia nigra program their own
cell death (apoptosis). In the dying cells on microscopic examination "Lewy
bodies" found that the protein alpha-synuclein contain, in which in Parkinson's
disease apparently something goes wrong. Here are recent inhibatoire effects of
FK506 binding proteins found, which might provide new insights in the treatment
of Parkinson's disease (Gerard, et al, 2010). Cellular lysis in other parts of
the nervous system generates olfactory disorders, disorders of autonomic
nervous system, mental disorders (depression, loss of initiative) and cognitive
impairment (memory, speed of information processing and executive functions).
By identifying the overall problem through well mapping, we can provide more
structure in terms of both medication, motor skills, cognition, mood and
quality of life. The newly developed planning stages of the short-stay plays on
this (see also PSS concept in annex). As a result of demographic developments
is a significant increase (47%) of the number of people with Parkinson's
disease expected between 2005 and 2025. (Http://www.nationaalkompas.nl) The
cost of care for Parkinson's disease amounted to 176.8 million euros in 2005.
That is 0.3% of total healthcare costs in the Netherlands and 4.6% of the total
cost of health care costs incurred in diseases of the nervous system and
sensory organs (Poos et al, 2008). The majority (68%) of the cost is
attributable to the elderly sector, 12% of hospital and specialist medical
care, primary care and 10% to 7% for medicines and tools.

Effectiveness and costs of a short-stay nursing home in intervention compared
with the 'regular' care to patients in end-stage Parkinson's disease.

Study Design Research questions:
The most important indicator of the research question is:
1. What is the effectiveness of the short-stay intervention compared to
standard care in the functional status of the Parkinson's patient?

Then looking at the answers to the following questions:
2. What is the effectiveness of short-stay concept in motor status, cognition,
behavior, mood and quality of life of the Parkinson's patient?
3. What is the effect of a short stay at the direct costs of intervention in
nursing home admissions and consultations in the first and second lines, as
well as medication, medical and paramedical care at home? Ie what is cost
effectiveness, the balance between costs and effects of short-stay compared
with standard care in terms of incremental costs.

There is no damage to be expected as a result of the tests. Indeed, the
treatment will aim and promote the well-being of patients.