Admission of Parkinsonian patients to a neurological ward in a community hospital.

Hospitalization is a significant factor contributing to health care costs related to management of Parkinson's disease (PD) patients. We reviewed reasons for admission of PD patients to our Neurological Department over a 6-year period. Thereafter, we applied an "open door" policy to try to diminish the number of hospitalizations. Case records including patient data, disease duration, staging, reasons for admission, and motor, mental and general medical status of PD patients admitted to the Neurology Department over a 6-year period were reviewed. Out of 1,920 admissions, 143 were PD patients. All PD admissions were through the emergency department (non-elective). Motor complications were the reason for admission in 37%, psychosis in 24%, general medical problems in 14%, and a combination of motor and psychiatric in 25%. Drug-induced psychosis was the most significant cause of repeated and prolonged admissions (29% of patients). As motor and psychiatric complications are the commonest causes for admission, improved community-based care to "fine tune" medication appeared to be a priority. After analyzing our results, we instituted an "open door" policy, where patients are free to come to the Parkinson's clinic without appointment. This policy should improve control of PD symptoms and diminish hospitalizations.