Rutgers study examines discrepancies in accessibility of epilepsy treatment
Rutgers researchers recently conducted a study on the disparities in access to epilepsy treatments for those in racial or minority groups.
Brad Kamitaki, an assistant professor in the Department of Neurology at Robert Wood Johnson Medical Center (RWJMC) and the lead author of the study, said there is not a large amount of scholarly research dedicated to examining disparities in epilepsy treatment.
In order to expand this field of study, he said he wanted to examine the population of people with epilepsy in New Jersey and discern what obstacles people face when trying to receive epilepsy treatment.
Kamitaki said the accessibility of these epilepsy services was analyzed against the variables of race, ethnicity and insurance. The study used a database of state hospitalization records from the Agency of Healthcare Research and Quality to determine whether there is equitable epilepsy care for all patients.
"We saw some indication that Black patients — especially those with Medicaid and private insurance — went to the (emergency department) a lot more and did not get the services relative to the number of times they went to the ED," he said in regard to the records. "Then for Hispanic, Latinx and Asian Pacific Islanders, it really depended on their insurance type but … some members of those groups also did not get admitted to the epilepsy unit as much as others."
Specialized care is important for individuals with epilepsy because the disease has many variations in symptoms and treatment, Kamitaki said. Care often needs to be specific and monitored in order to determine what kinds of treatment methods are best for the patient.
To find the correct treatment plan, patients can be admitted to an epilepsy monitoring unit (EMU) in a hospital where their electrical brain activity can be examined using electroencephalography as well as visually recorded for their physical reaction, he said.
Though there are various factors that affect the accessibility of these services to patients including race, location and ability to speak English, Kamitaki said. He said that many people of color are uninsured or have government-based insurance, which makes them less likely to receive the best care for their epilepsy.
The services of the EMU or of an epilepsy specialist can cost thousands of dollars, and for those who are uninsured, the hospital will not admit them without a guarantee of payment.
"Private practice neurologists will often not take Medicaid because it's very low reimbursement. They, like at (Robert Wood Johnson University Hospital), do not have a system that can support them," Kamitaki said.
Kamitaki said wealth-related structural factors could also affect how far a patient lives from an epilepsy treatment center, which would mean they have no physical access to the services they need.
He said that his study is an exploratory analysis of what epilepsy care is like in New Jersey and that some of the study’s results are not conclusive enough to make definitive statements about the influence of race on epilepsy care. Still, Kamitaki said it could serve as a starting point for further research on the subject.
Kamitaki said New Jersey’s geographical layout allows many patients to more easily access health care, which can allow the state to further health care equity. The state should continue to consider different solutions to lessen disparities in care for minority groups and promote a more personalized health care model.
"A lot of studies, I think, point out disparities and differences without looking at solutions. We're also doing a study right now where we asked people … how we can improve epilepsy care in New Jersey to find solutions that are important and also feasible for a wide variety of stakeholders," Kamitaki said.
