Clinical Neuroscience

[Health insurance aspects of physiotherapeutic care of neurology disorders in outpatient care]

MOLICS Bálint1,2, BONCZ Imre1, LEIDECKER Eleonóra2, HORVÁTH Cs. Zoltán1,3, SEBESTYÉN Andor1,4, KRÁNIZC János2, KOMOLY Sámuel5, DÓCZI Tamás6, OLÁH András7

NOVEMBER 20, 2015

Clinical Neuroscience - 2015;68(11-12)

DOI: https://doi.org/10.18071/isz.68.399

[Background and purpose – The aim of our study is to analyse the ambulatory rehabilitation care of patients with neurological disorders in the field of physiotherapy. Methods – Data derive from the database of the Hungarian National Health Insurance Fund Administration (year 2009). The analyses covered patients with diagnosis „G00–G99 Diseases of the nervous system” according to the International Classification of Diseases and underwent physiotherapy treatment. Results – In 2009 altogether 190986 patients with neurological disorders received physiotherapy treatment in outpatient care, representing 1331675 cases and got 388.215 million Hungarian Forint health insurance reimbursement. The number of patients with nerve, nerve root and plexus disorders was 39 patients/10 000 population for males and 66 patients/10000 population for females. The number of patients with cerebral palsy and other paralytic syndromes was 49 patients/10000 population for males and 35 patients/10000 population for females. The number of patients with episodic and paroxysmal disorders was 33 patients/10000 population for males and 52 patients/10000 population for females. Conclusion – In the outpatient physiotherapy care the utilization indicators of females were higher in nerve, nerve root and plexus disorders and episodic and paroxysmal disorders, while in cerebral palsy and other paralytic syndromes the utilization of male was higher. There are important age and gender inequalities in the utilization of physiotherapy care of patients with neurological disorders.]

AFFILIATIONS

  1. Pécsi Tudományegyetem, Egészségtudományi Kar, Egészségbiztosítási Intézet, Pécs
  2. Pécsi Tudományegyetem, Egészségtudományi, Kar Fizioterápiás és Táplálkozástudományi Intézet, Pécs
  3. Gyógyszerészeti és Egészségügyi Minôség- és Szervezetfejlesztési Intézet (GYEMSZI), Térségi Egészségszervezési Központ (TESZK), Pécs
  4. Országos Egészségbiztosítási Pénztár (OEP), Dél-Dunántúli Területi Hivatal, Pécs
  5. Pécsi Tudományegyetem, Klinikai Központ, Neurológiai Klinika, Pécs
  6. Pécsi Tudományegyetem, Klinikai Központ, Idegsebészeti Klinika, Pécs
  7. Pécsi Tudományegyetem, Egészségtudományi Kar, Ápolás és Betegellátás Intézet, Pécs

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[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

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HEROLD Róbert, VARGA Eszter, MIKE Andrea, TÉNYI Tamás, SIMON Mária, HAJNAL András, FEKETE Sándor, ILLÉS Zsolt

[Introduction – Mentalization is the ability to attribute mental states (intentions, desires, thoughts, emotions) to others, and hence to predict their behaviour. This ability fundamentally determines our participation in social relationships and adaptation to society. A significant proportion of the disorders of the central nervous system (CNS) affects those brain structures and neurotransmitter systems that play a role in the mentalizing processes. Accordingly, a number of CNS disorders may be associated with mentalizing deficits, which may affect the outcome of these diseases. Here, we review recent research on mentalizing abilities in neurological diseases. Methods – An internet database search was performed to identify publications on the subject. Results – Sixty-two publications in English corresponded to the search criteria. These publications reported impaired mentalization in several neurological disorders (e.g. epilepsy, Parkinson’s disease, multiple sclerosis, dementias, traumatic brain injury). Discussion – The results indicate that a number of neurological disorders associate with mentalizing deficit. This deficit is often present in the early stages of the diseases and has a prognostic value, which in turn emphasizes the importance of the early detection and adequate rehabilitation.]

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