Regular access to care could have a major impact on outcomes for neurological patients.
Blacks and Hispanics are less likely than their white counterparts to see physicians for multiple sclerosis or other neurological disorders, according to a new study including nearly 17,000 patients.
Overall, Hispanics were 40% less likely to see an outpatient neurologist, compared to whites, and Blacks were 30% less likely.
Study author Altaf Saadi, MD (pictured), Massachusetts General Hospital and Brigham and Women’s Hospital, said regular access to care could have a major impact on outcomes for neurological patients.
“Previous research has shown that having neurologists involved in the care of people with neurologic conditions reduces serious side effects and hospitalizations for acute problems,” Saadi said. “So unequal access to outpatient care may be resulting in unnecessary medical and financial costs.”
The findings are based on 8 years of results from the Agency for Healthcare Quality and Research’s (AHQR) Medical Expenditure Panel Survey, which studied patient and provider health habits nationwide. The AHQR is an office within the US Department of Health and Human Services.
Altogether, the data included approximately 279,000 patients. Of those patients, 16,936 reported that they had been diagnosed with a neurological disorder. The most common disorder among the group was neurological cardiovascular issues, which 3,338 patients reported. A total of 399 patients in the study had multiple sclerosis.
Of the patients with neurological issues, 1.18% of Hispanics had visited a neurologist in an outpatient setting; 2.06% of black patients had done the same. Among white patients, 3.26% reported visiting a neurologist. The study did not break out other ethnic or racial groups.
“These disparities are concerning not only because racial and ethnic minorities represent 28% of Americans, but also because all Americans should have equitable access to health care regardless of who they are, where they live, or what resources they have,” Saadi said, in a press release.
Aside from outpatient neurologist visits, blacks with neurological conditions were significantly more likely to have visited an emergency department, with 12.6 visits per 100 patients. Whites and Hispanics each had emergency department visit rates of 7.7 visits per 100 patients. Black neurology patients also had double the number of inpatient hospital stays, compared to whites and Hispanics.
Saadi identified a number of possible causes for the disparities like cultural or religious attitudes toward healthcare and disease, language barriers for non-English speakers, or a lack of equal geographic distribution of neurologists.
The new study isn’t the first to highlight racial disparities in MS patients. A 2013 study out of Kaiser Permanente, in California, found that blacks in general — and black women in particular – had a significantly higher risk of being diagnosed with MS.
The National Multiple Sclerosis Society also points to research indicating that symptoms can vary among racial and ethnic groups. For instance, blacks appeared to be more likely to suffer relapses in their MS, and are more likely to suffer greater disability.
Further research is needed to determine whether those apparent disparities in disease course are the result of genetic differences or whether they’re related to the disparities in access to care highlighted by the new research.
Saadi said additional multicultural care training for healthcare staff, better patient education, and the recruitment of more minorities into the field of neurology would likely help reduce disparities related to access to care.
Saadi’s study, titled “Racial disparities in neurologic health care access and utilization in the United States” was published May 17 in Neurology.