Evaluating racial/ethnic variations in outpatient epilepsy care

Racial differences in Emergency Department visits for seizures

“…This racial disparity has been observed in many medical subspecialties, and specifically in neurology where other groups have reported similar findings. One study found that follow-up visits in neurology are the main source of care for white patients with epilepsy, but significantly less so for black and Hispanic patients [9]. Similar to our study, Bautista et al (2011) found that African Americans with epilepsy had lower rates of AED adherence compared to whites [10].…”

Social determinants of health in epilepsy

“…Examples of provider-based factors include communication skills and attitudes toward the patient, including stigma or stereotyping/prejudice. For example, one study showed that black patients received significantly less of recommended care and had more difficulty getting follow-up appointments compared with nonHispanic whites [53], suggesting a potential provider bias. Many studies have examined patient-provider relations, but little is known about the role of these factors in epilepsy and how they are linked to SDH.…”

“…Many studies have examined patient-provider relations, but little is known about the role of these factors in epilepsy and how they are linked to SDH. It remains unclear if disparities in care are related to poor resources, patient-provider relations, provider practices, or patient characteristics [35], but high-quality, patient-centered care is essential to improve the lives of PWE and their families, and quality-of-care studies are urgently needed [1,53].…”

Mind the gap: health disparities in families living with epilepsy are significant and linked to socioeconomic status

“…To accomplish these goals, collaborative efforts that ensure larger representation of diverse groups of PWE from various settings and countries are required (Szaflarski et al ., 2006). Both patient‐reported and provider‐documented aspects of care should be investigated, longitudinally and with comparative groups of patients suffering from other chronic disorders, focusing on intervention trials (Avetisyan et al ., 2013; Burneo et al ., 2009; Begley et al ., 2011). From a public health perspective, providers, administrators, advocates and policy makers should include the care takers into their agenda and promote actions that eliminate inequities for families living with epilepsy.…”

“…Disparities in health care are defined as systematic differences in the use or receipt of health care services between people who have comparable need for them (Vickrey and Shapiro, 2009). For people with epilepsy (PWE), there is limited, but growing, evidence of existing disparities (Theodore et al ., 2006; Szaflarski et al ., 2006; Burneo et al ., 2009; Bautista and Jain, 2011; Avetisyan et al ., 2013; Kroner et al ., 2013). Prior studies have shown that patients with low SES demonstrate more frequent use of the emergency room, more hospitalizations and more visits to a general practitioner for their care.…”