Objective:

To measure the access to epilepsy surgery or neuromodulation devices in adult non-English-speaking compared to English-speaker epilepsy patients in Inland Empire, California.

Background:

Drug-resistant epilepsy (DRE) comprises 40% of patients with focal epilepsy requiring treatment with epilepsy surgery or neuromodulation devices. Numerous studies show that delayed optimal care correlates with poor quality of life outcomes and accumulating socio-economic disabilities over the patient's lifespan. Furthermore, multiple studies suggest that non-English speakers in the United States have limited and delayed access to healthcare compared to English speakers. This project examines time-to-access to optimal care for these two groups of patients with similar demographics to identify factors accounting for the found disparity. 

Design/Methods:

We retrospectively reviewed 206 presented cases in the pre-surgical conference from April 2020 to July 2023. We define the time-to-access optimal care, surgery, or neuromodulation as the time from the EMU admission to the first optimal surgical intervention. 

Results:

We studied 206 DRE patients who are candidates for further epilepsy surgery or neuromodulation care in Inland Empire, California, from April 2020 to July 2023, of which 164 (80%) are English speakers and 42(20%) non-English speakers while 47% of the population in Inland Empire are non-English speakers. Furthermore, 80 out of 164 English speakers (48%) and 19 out of 42 non-English speakers (45%) received optimal care. The time-to-access optimal care was 303 days for English speakers versus 404 days for non-English speakers, 101 (33%) days longer.   

Conclusions:

Our results provide evidence for optimal care disparities for non-English speakers in Inland Empire, California. This finding indicates that most non-English speakers are not referred to an epileptologist for optimal care evaluation. When non-English speakers get referred for an evaluation, they receive delayed care.