Abstracts

Rationale: A focus on health disparities and inequities affecting Spanish-speaking Hispanic persons with epilepsy (HPWE) can be used to improve treatment compliance and outcomes. The objective of this study was to characterize HPWEs and English-speaking persons with epilepsy (EPWEs) regarding socioeconomic features, treatments, and treatment compliance. We hypothesized that HPWEs would differ on health insurance coverage which could affect the type (generic vs brand) of antiseizure medications (ASMs) they were prescribed as well as the number and type of medical encounters they completed.


Methods:


This is a retrospective study of 53 HPWEs (40 men, 13 women) and 55 EPWEs (28 men, 27 women).. Demographic (age, gender, health insurance [uninsured, government funded, private]) and clinical (seizure frequency, ASM types, diagnostic tests, medical encounters, and patient compliance) data was collected. Socioeconomic status was calculated utilizing the Neighborhood Atlas website to identify Area Deprivation Indices (ADI) ranging from 0-100 (100 indicates the highest level of "disadvantage").


Results: Demographically, HPWEs were older (42.08± 17.28) than EPWEs (33.38 ±17.74) t(-2.553), p < 0.006) and had experienced epilepsy for a longer time (21.04 ±14.52) than EPWEs (15.08 ±12.42) t(2.19), p < 0.015). With regard to socio-economic status, HPWEs had a higher level of disadvantage (31.19 ± 17.14) than EPWEs (26 ± 12.81) t(-1.76), p < 0.039). As for health insurance type (government issued versus private), more HPWEs had no insurance or had health insurance from a government source as compared to EPWEs (p < .0006). As for testing, less MRIs were conducted with HPWEs (0.94 ± 2.0) than EPWEs (1.53 ±1.22) t(-1.82), p < 0.036) and a trend of HPWEs having more CT scans (0.64 ± 1.43) than EPWEs (0.33 ± 0.84) t(-1.39), p < 0.082) was seen. No differences were found between patient groups on number of canceled, rescheduled or missed appointments, in-person or telemedicine follow ups, or on types of ASMs that were prescribed. Lastly, in our practice HPWEs were much more likely to be assigned a Spanish-speaking physician than English-speakers ( p < .003).


Conclusions: Our sample of HPWEs was found to differ from EPWEs; their socio-economic status was lower and less of this group had access to private health insurances. Despite this, they did not differ from EPWEs on the type of ASMs (brand name versus generic) they were prescribed nor on the medical services they received, except for number of MRIs. The fact that Spanish-speaking patients did not miss/cancel appointments more than EPWEs may be partly due to most HPWEs being assigned Spanish-speaking physicians. In sum, overall, Spanish-speaking PWEs were receiving comparable care (medical encounters, ASMs) except for number of MRIs.


Funding: None