Socioeconomic status, health care use, and outcomes: persistence of disparities over time
| Autor: | Charles, Begley, Rituparna, Basu, David, Lairson, Thomas, Reynolds, Stephanie, Dubinsky, Michael, Newmark, Forbes, Barnwell, Allen, Hauser, Dale, Hesdorffer |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Medically Uninsured Epilepsy Adolescent Office Visits General Practice Health Services Middle Aged Health Services Accessibility Treatment Outcome Social Class Socioeconomic Factors Health Care Surveys Surveys and Questionnaires Humans Female Healthcare Disparities Child Emergency Service Hospital Minority Groups Aged |
| Zdroj: | Epilepsia. 52(5) |
| ISSN: | 1528-1167 |
| Popis: | To determine the persistence of disparities in health care use and outcomes in socioeconomically diverse populations of epilepsy patients.We followed patients for a year at one clinic in Houston and two in New York City that serve predominantly low-income, minority, Medicaid-insured, or uninsured patients, and a fourth clinic in Houston that serves a more balanced racial/ethnic and higher socioeconomic status (SES) population. We interviewed the patients several times regarding health care use, seizures, side effects, and outcomes, and examined differences between the patients at the three low-SES clinics and the patients at the high-SES clinic.After controlling for patients' age, gender, race/ethnicity, marital status, seizures, and side effects we found that low SES patients had consistently higher use of the hospital emergency room and more visits to a general practitioner. Hospitalizations were also consistently higher but the differences were not significant in most periods. Neurologist visits were relatively similar. Patients at the low SES sites also had a greater likelihood of having uncontrolled seizures, drug-related side effects, to be stigmatized, and have a lower overall quality of life throughout the study period.These findings suggest the persistence of SES-related disparities in health care use and outcomes among patients with epilepsy who are receiving regular care. |
| Databáze: | OpenAIRE |
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