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.