Health insurance and transportation barriers impact access to epilepsy care in the United States.

Autor: Kamitaki BK; Rutgers-Robert Wood Johnson Medical School, Department of Neurology, 125 Paterson Street, Suite 6200, New Brunswick, NJ 08901, USA. Electronic address: brad.kamitaki@rutgers.edu., Maniar S; Rutgers-Robert Wood Johnson Medical School, Department of Neurology, 125 Paterson Street, Suite 6200, New Brunswick, NJ 08901, USA. Electronic address: sm2551@rwjms.rutgers.edu., Rambhatla R; Rutgers-Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: vrr27@rwjms.rutgers.edu., Gao K; Rutgers-Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: kg615@rwjms.rutgers.edu., Cantor JC; Rutgers University, Center for State Health Policy, 112 Paterson Street, 5th Floor, New Brunswick, NJ 08901, USA. Electronic address: jcantor@ifh.rutgers.edu., Choi H; Columbia University, Department of Neurology, 710 West 168th Street, 7th Floor, New York, NY 10032, USA. Electronic address: hc323@cumc.columbia.edu., Bover Manderski MT; Rutgers School of Public Health, Department of Biostatistics and Epidemiology, 683 Hoes Lanes West, Piscataway, NJ 08854, USA; Rutgers Institute for Nicotine and Tobacco Studies, 303 George Street, Suite 500, New Brunswick, NJ 08901, USA. Electronic address: bovermi@ints.rutgers.edu.
Jazyk: angličtina
Zdroj: Epilepsy research [Epilepsy Res] 2024 Sep; Vol. 205, pp. 107424. Date of Electronic Publication: 2024 Aug 08.
DOI: 10.1016/j.eplepsyres.2024.107424
Abstrakt: Purpose: Inconsistent access to healthcare for people with epilepsy results in reduced adherence to antiseizure medications, increased seizure frequency, and fewer appropriate referrals for epilepsy surgery. Identifying and addressing factors that impede access to care should consequently improve patient outcomes. We hypothesized that health insurance and transportation affect access to outpatient neurology care for adults living with epilepsy in the United States (US).
Methods: We conducted a retrospective cross-sectional study of US adults with active epilepsy surveyed via the National Health Interview Survey (NHIS) in 2015 and 2017. We established whether patients reported seeing a neurologist in the past year and used multiple logistic regression to determine whether health insurance status and transportation access were associated with this outcome.
Results: We identified 735 respondents from 2015 and 2017, representing an estimated 2.98 million US adults with active epilepsy. After adjusting for socioeconomic and seizure-related co-variates, we found that a lack of health insurance coverage was associated with no epilepsy care in the past year (adjusted odds ratio [aOR] 0.22; 95 % confidence interval [CI]: 0.09 - 0.54). Delayed care due to inadequate transportation (aOR 0.42; 95 % CI: 0.19 - 0.93) also resulted in reduced patient access to a neurologist.
Conclusion: Due to the inherent nature of their condition, people with epilepsy are less likely to have employer-sponsored health insurance or consistent driving privileges. Yet, these factors also impact patient access to neurological care. We must address transportation and insurance barriers through long-term investment and partnership between community, healthcare, and government stakeholders.
Competing Interests: Declaration of Competing Interest None of the authors has any conflict of interest to disclose.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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