Health-care access among adults with epilepsy: The US National Health Interview Survey, 2010 and 2013

• Type of Material: Article
• Authors: David Thurman, Emory University; Rosemarie Kobau, US Centers for Disease Control and Prevention; Yao-Hua Luo, US Centers for Disease Control and Prevention; Sandra Helmers, Emory University; Matthew M. Zack, US Centers for Disease Control and Prevention
• Language: English
• Date: 2016-02-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.yebeh.2015.10.028
• Title of Journal or Parent Work: Epilepsy and Behavior
• ISSN: 1525-5050
• Volume: 55
• Start Page: 184
• End Page: 188
• Keywords: United States; Insurance; Surveillance; MEDICAID; DISPARITIES; STATES; Clinical Neurology; SURVEILLANCE; Psychiatry; Epilepsy; Life Sciences & Biomedicine; PREVALENCE; SELF-REPORTED EPILEPSY; Access to care; Behavioral Sciences; Neurosciences & Neurology; Science & Technology; Epidemiology; PSYCHOLOGICAL DISTRESS; IMPACT; POPULATION
• Research Categories: Biology, Neuroscience; Health Sciences, Public Health

Abstract

Introduction: Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care. Materials and methods: We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity. Results: Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR = 3.58) and less likely to have private health insurance (RR = 0.58). Adults with active epilepsy were also less likely to be employed (RR = 0.53) and much more likely to report being disabled (RR = 6.14). They experience greater barriers to health-care access including an inability to afford medication (RR = 2.40), mental health care (RR = 3.23), eyeglasses (RR = 2.36), or dental care (RR = 1.98) and are more likely to report transportation as a barrier to health care (RR = 5.28). Conclusions: These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention.