Frequent seizure and epilepsy‐related emergency department visits in the United States: A retrospective cohort study
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Le résumé fourni par la source
OBJECTIVES: Health disparities impact access to epilepsy care in the United States, but how these factors contribute to recurrent emergency department (ED) visits is unclear. We hypothesized that people who (1) were uninsured or had public health insurance, (2) belonged to minoritized racial/ethnic groups, or (3) resided in low-income zip codes were more likely to have frequent ED visits for seizure or epilepsy. METHODS: This was a retrospective cohort study of adult patients presenting to the ED in four U.S. states (Florida, Maryland, New York, and Wisconsin) with a primary diagnosis of seizure or epilepsy. We tracked ED visits for each patient longitudinally between 2016 and 2018. We performed a multivariable logistic regression analysis evaluating the association of the above factors with a high (>2) vs low (1-2) number of ED visits. RESULTS: We identified 200 962 patients who visited the ED for seizure/epilepsy, of whom 28 598 (14.7%) presented >2 times during the study period. Compared to private insurance, individuals with Medicare (adjusted odds ratio [aOR] 1.90, 95% confidence interval [CI]: 1.82-1.99), Medicaid (aOR 2.01, 95% CI: 1.93-2.09), or no insurance (aOR 1.55, 95% CI: 1.48-1.62) had increased odds of high ED visits. Black patients had a 60% higher odds of frequent ED visits compared with White patients (aOR 1.60, 95% CI: 1.55-1.65). However, these disparities were attenuated for Black patients with Medicare and Medicaid, vs private insurance. High ED use was not seen in other racial/ethnic groups. Finally, patients living in low-income zip codes (0-25th percentile of median household income; aOR 1.65, 95% CI: 1.58-1.73) were more likely to be in the high ED visit group, compared with the highest income quartile. SIGNIFICANCE: Racial/ethnic and socioeconomic inequities likely contribute to frequent ED visits for seizures, as evidenced by our findings from four U.S. states. Effective, multi-level interventions are needed to reduce disparities for those most affected.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Frequent seizure and epilepsy‐related emergency department visits in the United States: A retrospective cohort study
- Date Crossref
- 05/07/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The State University of New Jersey Rutgers pays non établi dans la noticeUniversité ou école supérieure
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Johnson University pays non établi dans la noticeUniversité ou école supérieure
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Columbia University Department of Neurology pays non établi dans la noticeUniversité ou école supérieure
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Department of Neurology Rutgers‐Robert Wood Johnson Medical School New Brunswick New Jersey USA pays non établi dans la noticeInstitution
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Rutgers‐Robert Wood Johnson Medical School Piscataway New Jersey USA pays non établi dans la noticeInstitution
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Rutgers-Robert Wood Johnson Medical School pays non établi dans la noticeInstitution
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Department of Biostatistics and Epidemiology Rutgers University School of Public Health Piscataway New Jersey USA Department of Biostatistics and Epidemiology pays non établi dans la noticeUniversité ou école supérieure
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Rutgers School of Nursing Newark New Jersey USA pays non établi dans la noticeUniversité ou école supérieure
Rutgers — The State University of New Jersey, Johnson University et Department of Neurology — Columbia University, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.