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J Huntingtons Dis. 2016 Jun 27;5(2):207-13. doi: 10.3233/JHD-160192.

Health Care Delivery Practices in Huntington's Disease Specialty Clinics: An International Survey.

Author information

1
Department of Neurology, Oslo University Hospital, Oslo, Norway.
2
Institute of Health and Society, University of Oslo, Oslo, Norway.
3
Department of Clinical Genetics, NHS Grampian, Aberdeen, Scotland, UK.
4
Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK.
5
Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
6
HD Reach, Raleigh, NC, USA.
7
Pacific Northwest University of Health Sciences, Yakima, WA, USA.
8
Huntingtons Disease Drug Works, Lake Forest Park, WA, USA.
9
Department of Neurology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
10
CHDI Management/CHDI Foundation, Princeton, NJ, USA.
11
The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, NH, USA.
12
Centre for Movement Disorders, Toronto, ON, Canada.
13
Struthers Parkinson's Center, Golden Valley, MN, USA.
14
Hennepin County Medical Center, MN, USA.

Abstract

BACKGROUND:

Little is known about the organization of clinical services for Huntington's disease (HD).

OBJECTIVE:

To describe how health care services are organized and delivered in HD-clinics taking part in or eligible for the Enroll-HD study.

METHODS:

In 2014, a 69-item survey was administered to sites taking part in or eligible for the Enroll-HD study.

RESULTS:

Of 231 sites surveyed, 121 (52.2%) sites in Europe, North America, Latin America, and Oceania responded. Most sites in the sample serve large populations, with 61.1% serving more than 1.5 million people, and a further 33% serving >500,000. Almost all (86.0%) centers see patients from outside their region. The majority of centers (59.7%) follow 50-199 patients, 21.9% care for more than 200. Most centers provide care in all stages of HD, and nearly all review pre-symptomatic cases. Multidisciplinary case reviews are offered in 54.5% of sites, with outreach clinics offered by 48.1%. Videoconferencing and telemedicine are used by 23.6%. Separate consultations for caregivers are offered in more than half of the centers. Most centers (70.4%) report following published guidelines or local care pathways for HD.

CONCLUSIONS:

Most centers serve a large population and use a multidisciplinary approach. The survey gives insight into factors underpinning HD service delivery globally. There is a need for more in-depth studies of clinical practice to understand how services are organized and how such features may be associated with quality of care.

KEYWORDS:

Huntington’s disease; health services; quality of health care

PMID:
27372053
PMCID:
PMC4942722
DOI:
10.3233/JHD-160192
[Indexed for MEDLINE]
Free PMC Article

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