Social Determinants of Health Regarding Hospitalization and Comorbidities in a Nationally Representative Inpatient Sample of Individuals With and Without Multiple Sclerosis
Aneesh Kamath1, Lauren Krupp2, Kimberly O'Neill2
1NYU Grossman School of Medicine, 2NYU Langone Medical Center
Objective:
To identify hospitalization trends and comorbidities among patients with Multiple Sclerosis (MS relative to non-MS admissions) 
Background:

MS is a chronic neuroinflammatory disorder which can require hospitalization for establishing the diagnosis or managing disease related complications.

Design/Methods:

Data was leveraged from the Healthcare Cost and Utilization Project (HCUP), a nationally representative US government survey of hospital admissions. MS hospitalization cases were defined by a primary ICD-10 code of ‘G35’. Additional ICD-10 codes listed for a hospitalization (e.g. depression, anxiety, and pain) were analyzed as comorbidities. Demographics (age, race, ethnicity, insurance status) and comorbidities were compared between MS and non-MS admissions.

Results:

Between January 2019 and December 2019 there were a total of 25,155 MS admissions and 35,392,578 non-MS admissions. Mean age at admission was 45.9 years for MS versus 50.2 years for non-MS admissions (p < 0.001). MS admissions were 72% female compared to 55.8% (p < 0.001) for non-MS. For MS admissions, 58.3% of patients were White, 26.7% Black, and 10.3% Hispanic compared to non-MS admissions at 64.9%, 15.4%, and 12.4% respectively (p < 0.001). Patients with MS were more likely to have a diagnosis of anxiety (18.9% versus 10.2%, p < 0.001), chronic pain (10.5% versus 5%, p < 0.001), and depression (21.8% versus 9.9%, p < 0.001) compared to non-MS admissions. Among MS admissions, depression diagnoses were reported less often among Black vs. non-Black (16.6% versus 23.6%, p < 0.001), Hispanic vs. Non-Hispanic (13.8% versus 22.7%, p < 0.001), and patients on public vs. commercial insurance (19.1% versus 22.6%, p < 0.001).  

Conclusions:
MS patients have higher rates of anxiety, depression, and pain compared to non-MS patients. Minoritized groups with MS are less likely to be given a secondary diagnosis code for depression, anxiety or pain, possibly reflecting underdiagnosis of these conditions. 
10.1212/WNL.0000000000212935
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