Format

Send to

Choose Destination
J Neurol. 2017 Aug;264(8):1735-1745. doi: 10.1007/s00415-017-8560-6. Epub 2017 Jul 12.

Disparities in epilepsy surgery in the United States of America.

Author information

1
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Fegan 9, 300 Longwood Avenue, Boston, MA, 02115, USA.
2
Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
3
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
4
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
5
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Fegan 9, 300 Longwood Avenue, Boston, MA, 02115, USA. tobias.loddenkemper@childrens.harvard.edu.

Abstract

The aim is to describe the epidemiology of epilepsy surgery in children and adults in the United States. We performed a descriptive study of the National Inpatient Sample (NIS) for the year 2012 and the Kids' Inpatient Database (KID) for the period 2010-2012, the largest all-payer databases on inpatient data in the USA. These databases estimate 97% of all inpatient hospital discharges in the USA. In the KID, 12,899 (0.2%) of admission records had brain surgery and 600 of the 4900 (12.2%) admissions with focal refractory epilepsy underwent epilepsy surgery. Epilepsy surgery occurred in 60% of Whites, 7% of Blacks, 15% of Hispanics, and 10% of other races. In the NIS, 99,650 (0.3%) of admission records had brain surgery and 1170 of the 9775 (12%) admissions with focal refractory epilepsy underwent epilepsy surgery. Epilepsy surgery occurred in 69% of Whites, 7% of Blacks, 9% of Hispanics, and 8% of other races. In both the KID and the NIS, lower socioeconomic status was mildly underrepresented in epilepsy surgery. In both pediatric and adult admissions, there was an overrepresentation of Whites and underrepresentation of Blacks, which persisted after stratifying by socioeconomic status. Females were underrepresented in epilepsy surgery, but gender disparities were partially explained by differences in socioeconomic status. Epilepsy surgery is not equally distributed across races in the USA and these differences are not fully attributable to differences in socioeconomic status. Racial disparities in epilepsy surgery similarly affect children and adults.

KEYWORDS:

Epidemiology; Epilepsy; Epilepsy surgery; Ethics; Health services research

PMID:
28702686
DOI:
10.1007/s00415-017-8560-6
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center