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Wednesday, May 24, 2017

African-Americans More Likely Than Whites to Receive Parkinson’s Care in Hospital, Study Reports


African-Americans are more likely to receive care for Parkinson’s disease in a hospital emergency room and have more hospital stays than whites, according to a U.S. study.
Blacks also more likely to be treated for stroke in a hospital than whites, researchers said.
Another finding was that both African-Americans and Hispanic-Americans are more likely than whites to be treated for multiple sclerosis in hospitals than doctor’s offices or clinics.
The research dealt with differences in the rates at which African-Americans, Hispanic-Americans and whites with neurological conditions receive treatment at doctor’s offices versus hospitals. Whites have a higher rate of treatment in doctor’s offices.
“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 of Massachusetts General Hospital and Brigham and Women’s Hospital in Boston, said in a news release. “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.”
Researchers used Medical Expenditure Panel Survey information from 2006 to 2013 to find where patients with neurological diseases were treated. The information included patients’ demographic characteristics, including race; the health conditions they reported; their neurology-disease-related visits; and their healthcare costs.
Of the 279,103 people who took part in the survey, 6 percent, or 16,936, reported a neurological  condition. They included 397 with Parkinson’s, 399 with multiple sclerosis, 2,236 with epilepsy, 3,338 with cerebrovascular disease, and others with different disorders.
Two percent of all the survey participants, or 5,890, said they had visited neurologists in doctor’s offices or clinics. Together, they reported making 13,685 such visits.
African-Americans were about 30 percent less likely than whites to see a neurologist in an office, even when the researchers adjusted the data for demographic, insurance, and health-status differences. Hispanics were 40 percent less likely than whites to see a neurologist in an office.
Similarly, African-Americans with a neurological disorder were more likely to receive care in a hospital emergency room and to have more hospital stays than whites. African-Americans also had higher hospital treatment expenditures than whites.
“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 [doctor’s office] care may be resulting in unnecessary medical and financial costs.”
One factor that could play a role in races’ different treatment-setting patterns is divergent cultural beliefs about aging and disease. Another is that non-English speakers could be reluctant to go to doctor’s offices because of the language challenge. Still another is lack of doctor’s offices in many minority communities.
More studies are necessary to understand race-related treatment-setting disparities, and find ways to eliminate them, researchers 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 said.

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