Author Topic: (Abst.) Racial disparities in neurologic health care access and utilization in the US  (Read 14 times)

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Offline agate

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African-Americans are more often at a low-income level than white Americans. Doctors, notably specialists like neurologists, are reluctant to see patients with no medical insurance or with only Medicare or Medicaid coverage. Is it so surprising that African-Americans are using the ER more often than other people for neurologic conditions and that they might have let their conditions go untended to the point where they needed longer hospital stays?

Poorer people tend not to have cars, and transportation to and from medical care is often a problem. Is it surprising that poorer African-Americans have problems getting into see specialist doctors who are trying hard to keep their distance from them?

These facts are a sad commentary on the US medical care system.

From PubMed, May 19, 2017:
Quote
Neurology. 2017 May 17.

Racial disparities in neurologic health care access and utilization in the United States

Saadi A1, Himmelstein DU2, Woolhandler S2, Mejia NI2.

Author information

1
From Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston. asaadi@partners.org.
2
From Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston.

OBJECTIVE:

To evaluate racial and ethnic differences in the utilization of neurologic care across a wide range of neurologic conditions in the United States.

METHODS:

We analyzed nationally representative data from the 2006-2013 Medical Expenditure Panel Survey (MEPS), including information on demographics, patient-reported health conditions, neurology visit rates, and costs.

Using diagnostic codes, we identified persons with any self-identified neurologic disorder except back pain, as well as 5 subgroups (Parkinson disease, multiple sclerosis, headache, cerebrovascular disease, and epilepsy). To assess disparities in neurologic care utilization, we performed logistic regression analyses of outpatient department neurologic care visit rates and expenditures for each racial ethnic group controlling for age, sex, health status, socioeconomic characteristics, and geographic region of care.

RESULTS:

Of the 279,103 MEPS respondents, 16,936 (6%) self-reported a neurologic condition; 5,890 (2%) received a total of 13,685 outpatient neurology visits. Black participants were nearly 30% less likely to see an outpatient neurologist (odds ratio [OR] 0.72, confidence interval [CI] 0.64-0.81) relative to their white counterparts, even after adjustment for demographic, insurance, and health status differences. Hispanic participants were 40% less likely to see an outpatient neurologist (OR 0.61, CI 0.54-0.69). Among participants with known neurologic conditions, blacks were more likely to be cared for in the emergency department, to have more hospital stays, and to have higher per capita inpatient expenditures than their white counterparts.

CONCLUSIONS:

Our findings highlight racial and ethnic inequalities in the utilization of neurologic care in the United States.

https://www.ncbi.nlm.nih.gov/pubmed/28515272





SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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More on this sad situation in Medpage Today, May 17, 2017--"Ethnic disparities a problem in neurologic care":

https://www.medpagetoday.com/Neurology/GeneralNeurology/65385?xid=nl_mpt_DHE_2017-05-18&eun=g345846d0r&pos=2





SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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