Black, Hispanic Americans Less Likely to See a Neurologist

They more often wind up in the ER and face higher medical costs than white patients, study shows

By Mary Elizabeth Dallas

Wednesday, May 17, 2017

WEDNESDAY, May 17, 2017 (HealthDay News) -- Black and Hispanic people are less likely than white people to make an appointment to see a neurologist, according to a new U.S. study.

Researchers found that black people with conditions that affect the brain, such as Parkinson's disease and stroke, tend to be treated in the emergency room and end up in the hospital more often than their white peers.

"Our findings demonstrate that there are substantial racial and ethnic disparities in neurologic health care access and utilization in the United States," said study author Dr. Altaf Saadi, from Massachusetts General Hospital and Brigham and Women's Hospital in Boston.

"These disparities are concerning, not only because racial and ethnic minorities represent 28 percent of Americans, but because all Americans should have equitable access to health care regardless of who they are, where they live, or what resources they have," Saadi added in a news release from the American Academy of Neurology.

For the study, the researchers analyzed data compiled on close to 280,000 people over the course of eight years. Of these people, almost 17,000 reported having a neurologic disorder, such as Parkinson's disease, epilepsy, multiple sclerosis or other brain-related conditions.

The findings showed that more than 3,300 people had cerebrovascular disease, over 2,200 had epilepsy, almost 400 had multiple sclerosis and close to another 400 were diagnosed with Parkinson's disease. The researchers identified nearly 6,000 people who made about 13,700 outpatient visits to neurologists.

After excluding Asians and people of other races who only accounted for a tiny fraction of those involved, the investigators found Hispanic people were 40 percent less likely than whites to schedule an appointment with a neurologist.

Meanwhile, black people were 30 percent less likely to see one of these specialists. This was even after the researchers considered other factors that could play a role in access to health care, such as income and insurance status.

Once the researchers honed in on the patients with brain conditions, they found black Americans were more likely to have been treated in the emergency room. Black people were also admitted to the hospital about twice as often as white people and Hispanics.

Medical expenses were also much higher for black patients, with costs reaching $1,485 per person, compared to $599 for white patients.

"Previous research has shown that having neurologists involved in the care of people with neurologic conditions reduces serious side effects and hospitalizations for acute problems," Saadi said. "So, unequal access to outpatient care may be resulting in unnecessary medical and financial costs."

More research is needed to understand why these racial and ethnic disparities exist, but the study authors speculated they could stem from different cultural beliefs, attitudes about getting older and disease, as well as language barriers. Local access to a neurologist could also play a role, they added.

"Solutions could include initiatives to educate hospital staff about bias and multicultural care, increase the proportion of underrepresented minorities in the field of neurology, improve patient education about neurologic disorders and change institutional practices to provide more equitable care," Saadi suggested.

The findings were published online May 17 in the journal Neurology.

SOURCE: American Academy of Neurology, news release, May 17, 2017

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