Veronica Gaspar1, Ratna Bhavaraju-Sanka2
1Neurology, UT Health San Antonio, 2UT Health Science Center @ San Antonio
Objective:
This research project seeks to identify the social determinants of health (SDOH) faced by Myasthenia Gravis (MG) patients who receive care locally either at a university academic center or a county hospital-affiliated clinic, the latter of which is part of a safety net hospital system for uninsured and underinsured individuals.
Background:
The data on SDOH faced by MG patients is limited. More information is needed for health care providers to better address the needs of their patients.
Design/Methods:
We conducted a retrospective chart review of MG patients and collected data on demographics, home address, employment status, insurance coverage, comorbidities, health behaviors, emergency department (ED) visits, hospitalizations, most recent MG-ADL score, and clinic no-shows.
Home address was used to determine neighborhood disadvantage using the Area Deprivation Index (ADI) which is a validated tool reflecting 17 different domains of SDOH including education level, income, housing, and employment.
Results:
Included in this study, are a group of 39 patients seen at the county-affiliated hospital (group A) and 330 seen at the university academic center (group B). Group A had a higher percentage of Hispanic/Latino patients (69.2% vs 39.7%) and a higher proportion of Spanish speakers (25.6% vs 2.1%). Group A also had higher unemployment rates (35.9% vs 7.0%) and disability (17.9% vs 3.6%). Group A had lower use of private insurance (15.4% vs 63.3%) and greater usage of an income-based county-sponsored financial assistance program (23.1% vs 0.3%). More than half of Group A had homes in the most disadvantaged neighborhoods (ADI decile 9 and 10). Finally, Group A had higher rates of clinic no-shows, ED visits and hospitalizations.
Conclusions:
The two groups varied in demographics, employment, insurance coverage, and neighborhood disadvantage, and had different rates of clinic no-shows, ED visits and hospitalizations. More research is needed to better understand and address these disparities.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.