Characterizing the connection between Parkinson’s disease progression and healthcare utilization

Background and Objectives Parkinson’s disease (PD) progression can be characterized in terms of healthcare utilization by analyzing clinical events across different stages of disease. Methods PD progression was measured by the Hoehn & Yahr (H&Y) clinical rating scale and clinical events at each stage were evaluated. Natural language processing and a large language model were used to extract H&Y values from real-world data enabling a larger cohort than manually collected studies, and multi-state hidden Markov models were used for H&Y progression likelihood. Results Within the one year, most patients in H&Y stages 2-5 remained in the same stage. Stage transitions, when they occurred, were most frequently to the next higher stage. Higher H&Y stages were associated with discharges into long term care and higher rates of additional clinical events. Conclusions Stratifying key clinical events by H&Y score demonstrates the increases of health care utilization and economic burden with PD severity. Modelling the progression likelihood establishes a progression timeline and emphasizes the unmet need to identify treatment options that stop or slow these transitions.