Abstract Details

Title The Role of Social Determinants in Epilepsy Treatment Delays for Arizonans on Medicaid

Topic Health Care Disparities

Presentation(s) Health Care Disparities Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 008

Background

Up to one-third of newly diagnosed IWE in the US remain untreated up to 3 years after diagnosis, increasing the risk of adverse medical events, emergency department visits, and hospital admissions. It is likely that a confluence of social determinants play a role in this treatment delay, especially among the most vulnerable populations.

Objective Examine the underlying cause and extent of treatment delays for individuals with epilepsy (IWE) enrolled in Arizona’s Medicaid program.

Design/Methods Using Arizona Medicaid claims records from 2015-2019, a multinomial logistic model was built where patient’s demographics (age, race, gender and marital status), initial diagnosis setting, and social determinants based on enrollment data and Z-codes were assessed for their impact on epilepsy treatment delays. The model included three outcomes: treated within thirty days; treated after thirty days; and untreated.

Results Of the 5965 IWE identified, 43% were treated with a mean/median delay of 180 and 73 days, respectively. IWE diagnosed in inpatient settings were 2 times more likely to be treated within 30 days than those diagnosed in office settings. Those diagnosed in non-traditional settings were 5.9 times more likely to be untreated than IWE diagnosed in an office setting. Older IWE were more likely to be untreated or receive delayed treatment. Native Americans were 2.2 times more likely to be untreated compared to other ethnic groups or Caucasians. Widowed patients were 2.8 times more likely to be untreated relative to single patients. IWE experiencing homelessness were 1.9 times more likely to be untreated. Unemployed patients were 2.1 times more likely to receive delayed treatment.

Conclusions The extent of epilepsy treatment delays within the Arizona Medicaid population was less than previous research had found nationally. The most significant variables are care setting, age, race, marital status, homelessness, and poverty.

Authors/Disclosures
Joseph I. Sirven, MD, FAAN (Mayo Clinic) PRESENTER	Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurona. Dr. Sirven has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Sirven has received publishing royalties from a publication relating to health care. Dr. Sirven has received personal compensation in the range of $10,000-$49,999 for serving as a Host/ Co producer with WJCT Public Media. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant with Federal Aviation Administration .
Gregory Sprout	Mr. Sprout has nothing to disclose.
	No disclosure on file
Grant Simic	Grant Simic has received personal compensation for serving as an employee of UCB, Inc. Grant Simic has received stock or an ownership interest from UCB, Inc.
	No disclosure on file