US Blacks, Hispanics Less Likely to Get Neurological Care in Doctor’s Offices and Clinics

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by James Frederick, PA-C, MMSc |

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African- and Hispanic-Americans are less likely than whites to receive care for neurological diseases such as multiple sclerosis in a doctor’s office or clinic, according to a study.

Many of them end up in a hospital emergency room after failing to obtain treatment that could have helped them avoid an emergency, researchers said.

The study, “Racial disparities in neurologic health care access and utilization in the United States,” was published in Neurology.

Researchers used eights years of neurological-condition information in their study. They obtained it from the Medical Expenditure Panel Survey, a national database maintained by the Agency for Healthcare and Quality Research.

Almost 17,000 of the 279,103 people who participated in the survey said they had a neurological  condition such as multiple sclerosis, Parkinson’s disease, a cerebrovascular disease or epilepsy. Researchers then looked at where the patients obtained their care.

African-Americans were 30 percent less likely than whites, and Hispanic-Americans 40 percent less like, to see a neurologist in a doctor’s office or clinic. The data were adjusted for other variables that could have influenced the results, including patients’ ability to obtain access to care, income, health status and insurance status.

Another finding was that African-Americans were more likely to receive care in an emergency room than Hispanics or whites. For every 100 people receiving neurological care, African-Americans made 12.6 emergency room visits to receive it. The figures for Hispanics and whites were 7.7 visits per 100 people.

African-Americans also had more hospital stays than Hispanics and whites. The figures for African-Americans were 9.4 hospital stays for every 100 people receiving neurological care, versus 4.7 stays for Hispanics and 4.5 for whites.

Unsurprisingly, African-Americans’ hospital expenses were higher: an average of $1,485, versus $599 for whites.

“Our findings demonstrate that there are substantial racial and ethnic disparities in neurologic health care access and utilization in the United States,” Dr. Altaf Saadi, the author of the study, said in a press release. He is a physician at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston.

“These disparities are concerning not only because racial and ethnic minorities represent 28 percent of Americans, but because all Americans should have equitable access to health care, regardless of who they are, where they live, or what resources they have.” Saadi added.

Several factors could be at play in minorities’ ability to obtain care in doctor’s offices and clinics, the researchers said. These include cultural beliefs about disease and aging, the language obstacle that non-English speakers face in obtaining care, and the locations of hospital neurology services.

Researchers cautioned that study results did not include nursing homes, prisons and other institutional settings that include many patients with neurological conditions.

Additional studies are needed to try to increase equity in care, the team said.

“Solutions could include initiatives to education hospital staff about bias and multicultural care, increase the proportion of underrepresented minorities in the field of neurology, improve patient education about neurologic disorders and change institutional practices to provide more equitable care,” Saadi concluded.

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