Abstract Details

Title Disparities in Nationwide Distribution of Epilepsy Centers

Topic Health Care Disparities

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

Poster/Presentation
Number 005

Background Conservatively, 30-50% of the drug-resistant epilepsy population are potential surgical candidates. Despite abundant literature on disparities in access to specialized epilepsy care, significant gaps remain in investigating the role that socioeconomic factors and geographical location play in epilepsy surgery access.

Objective This study highlights the national disparities in specialized epilepsy care in the United States - specifically as it pertains to geographical and socioeconomic barriers to access.

Design/Methods Using the National Association of Epilepsy Centers accreditation guidelines, each of the 181 level IV epilepsy centers were plotted as points across two heat maps to visualize the location of centers: one shaded based on 2015 Centers for Disease Control epilepsy prevalence data, and one shaded based on the most recent 2017 Census data on ADI (Area Deprivation Index). A logistic regression was used to evaluate county-level ADI scores with the primary outcome of presence or absence of a level IV center in that county.

Results Many states do not have any level IV epilepsy centers (Alaska, Maine, Montana, Nevada, New Jersey, North and South Dakota, Vermont and Wyoming). In states with level IV epilepsy centers, our heat maps show that centers are clustered in areas of lower ADI (less disadvantaged areas) and that lower county-level ADI scores were associated with the presence or level IV centers overall (p < 0.0001).

Conclusions The concentration of specialized epilepsy centers in socio-economically privileged areas of lower ADI, accompanied by the absence of centers in a large portion of the Northwest demonstrates the barriers to access that patients are likely to experience based on their socioeconomic status and geographic location. Public health measures to remedy the existing access disparities, and further research into their mechanisms are needed.

Authors/Disclosures
Shreya Louis, MD (Stanford Neuroscience Health Center) PRESENTER	Miss Louis has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lara Jehi, MD (Cleveland Clinic Epilepsy Center)	Dr. Jehi has nothing to disclose.