2024 American Academy of Neurology Abstract Website

Objective:

To describe race differences in a cohort of people with MS.

Background:

MS is a common, chronic disease with a recognized race disparity. There is increased urgency to document, assess barriers, and reduce racial and economic disparities in care.

Design/Methods:

We performed a retrospective cohort analysis of patients seen at 18 outpatient neurology clinics within an academic health system between June 2018, and August 2023. Patient-Reported Outcomes Measurement Information System (PROMIS) were collected. We assessed associations between demographic variables and healthcare rate utilization (HRU) data at specific time points between HRU events and index neurology clinic visits using a logit model. Demographic data was combined with Health Plan claims HRU data in 2 domains (Hospitalization and Emergency Department (ED) treat and release all causes) at 7, 30 and 90-days from an index neurology clinic visit.

Results:

MS patient cohort included 1929 unique patients (5199 encounters; 75.8% females, 5.9% black, median age 53.2 years). The MS patient cohort showed significantly lower hospitalizations and ED visits, at 30- and 90-day time-points, compared to the general neurology cohort (N=64808, 62.6% females) (p<0.05). Black MS patients (106 patients, 238 encounters) correlated with increased ED visits at 30 and 90-day time-points compared to the general neurology cohort (p<0.05). Within the MS patient cohort: Black race also correlated with increased 90-day hospitalizations (p<0.05). Medicaid was the insurance in 30.7% of the black MS population and in 13.3% for white MS patient population. Higher pathologic scores in PROMIS measures (Anxiety>62, Depression>60) were present in the black MS population (29.4%, 31.9%) compared to white MS population (17.8%, 23.3%). In contrast, antidepressants were used in 42% of black MS patients and 55.9% of white MS patients.

Conclusions:

Black MS patients have associated higher unplanned HRU and pathologic PROMIS scores. The observed differences should guide development of targeted tools for timely care interventions.