Racial disparities in acute care utilization among individuals with myasthenia gravis

被引:0
作者
Qi, Cynthia [1 ]
Narayanaswami, Pushpa [2 ]
Anderson, Ashley E. L. [3 ]
Gelinas, Deborah [1 ]
Li, Yuebing [4 ]
Guptill, Jeffrey T. [1 ]
Amirthaganesan, Dakshinamoorthy [5 ]
Ward, Charlotte [6 ]
Panchal, Rupesh [7 ]
Goyal, Amit [8 ]
Phillips, Glenn [1 ]
机构
[1] Argenx US Inc, Boston, MA 02110 USA
[2] Beth Israel Deaconess Med Ctr, Dept Neurol, Boston, MA USA
[3] Houston Methodist, Dept Neurol, Houston, TX USA
[4] Cleveland Clin, Neuromuscular Ctr, Cleveland, OH USA
[5] ZS Associates, Bengaluru, Karnataka, India
[6] ZS Associates, Bethesda, MD USA
[7] ZS Associates, Thousand Oaks, CA USA
[8] ZS Associates, Princeton, NJ USA
关键词
myasthenia gravis; racial disparities; social inequalities; social determinants of health; healthcare resource utilization; acute care; myasthenic exacerbation; race; PARKINSONS-DISEASE; ETHNIC DISPARITIES; CRISIS; RISK; COMPLICATIONS; DIAGNOSIS; MORTALITY; ACCESS; IMPACT;
D O I
10.3389/fpubh.2025.1448803
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective In myasthenia gravis (MG), evidence on the impact of social determinants of health on disparities in disease burden and healthcare resource utilization is limited. This study aimed to investigate the independent association between race/ethnicity and acute care utilization during the 2 years post-diagnosis among patients with MG.Methods A retrospective cohort study was conducted among adults (>= 18 years) with newly diagnosed MG in the United States using Optum's de-identified Market Clarity Data from January 1, 2010, to December 31, 2019. Multivariable regression models were used to assess the association between acute care utilization and race/ethnicity, insurance, exacerbation at index, and other covariates.Results A total of 7,058 patients met the study inclusion criteria, of whom 57% (n = 4,052) identified as Caucasian, 6% (n = 445) African American, 3% (n = 235) Hispanic, 1% (n = 94) Asian, and 32% (n = 2,232) with missing race/ethnicity information. Compared with patients identifying as Caucasian, those identifying as African American had 37% higher odds of having an emergency department visit in year 1, and those identifying as Hispanic had 70% increase in odds of having a hospitalization event in year 2 post-diagnosis. Among other covariates, Medicaid usage, exacerbation at index, and number of outpatient visits were significantly associated with acute care utilization.Conclusion Racial disparities significantly impacted acute care utilization in the first 2 years post-MG diagnosis. Future studies should aim to examine specific factors that may contribute to disparities such as barriers to healthcare access, greater severity of MG symptoms, and poorly controlled disease.
引用
收藏
页数:11
相关论文
共 58 条
[11]   Myasthenia gravis: past, present, and future [J].
Conti-Fine, Bianca M. ;
Milani, Monica ;
Kaminski, Henry J. .
JOURNAL OF CLINICAL INVESTIGATION, 2006, 116 (11) :2843-2854
[12]   Delayed Parkinson's Disease Diagnosis among African-Americans: The Role of Reporting of Disability [J].
Dahodwala, Nabila ;
Karlawish, Jason ;
Siderowf, Andrew ;
Duda, John E. ;
Mandell, David S. .
NEUROEPIDEMIOLOGY, 2011, 36 (03) :150-154
[13]   Post-hoc analyses from the ADAPT clinical study demonstrate aggregate sustained benefit of Efgartigimod in generalized myasthenia gravis [J].
Dewilde, Sarah ;
Griffiths, Alison ;
Qi, Cynthia Z. ;
Phillips, Glenn ;
Gelinas, Deborah ;
Brauer, Edward ;
Mantegazza, Renato ;
Howard, James F. .
JOURNAL OF THE NEUROLOGICAL SCIENCES, 2024, 466
[14]   Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations [J].
Dresser, Laura ;
Wlodarski, Richard ;
Rezania, Kourosh ;
Soliven, Betty .
JOURNAL OF CLINICAL MEDICINE, 2021, 10 (11)
[15]   Burden of illness in patients with treatment refractory myasthenia gravis [J].
Engel-Nitz, Nicole M. ;
Boscoe, Audra ;
Wolbeck, Ryan ;
Johnson, Jonathan ;
Silvestri, Nicholas J. .
MUSCLE & NERVE, 2018, 58 (01) :99-105
[16]   The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review [J].
Ganguli, Arijit ;
Clewell, Jerry ;
Shillington, Alicia C. .
PATIENT PREFERENCE AND ADHERENCE, 2016, 10 :711-725
[17]   The humanistic burden of myasthenia gravis: A systematic literature review [J].
Gelinas, Deborah ;
Parvin-Nejad, Sara ;
Phillips, Glenn ;
Cole, Caroline ;
Hughes, Tom ;
Silvestri, Nicholas ;
Govindarajan, Raghav ;
Jefferson, Matthew ;
Campbell, Joanna ;
Burnett, Heather .
JOURNAL OF THE NEUROLOGICAL SCIENCES, 2022, 437
[18]  
Glasheen WP, 2019, AM HEALTH DRUG BENEF, V12, P188
[19]   Employment in Myasthenia Gravis: A Systematic Literature Review and Meta-Analysis [J].
Guastafierro, Erika ;
Tramacere, Irene ;
Toppo, Claudia ;
Leonardi, Matilde ;
Mantegazza, Renato ;
Bonanno, Silvia ;
Frangiamore, Rita ;
Raggi, Alberto .
NEUROEPIDEMIOLOGY, 2020, 54 (04) :304-312
[20]   COST ANALYSIS OF MYASTHENIA GRAVIS FROM A LARGE U.S. INSURANCE DATABASE [J].
Guptill, Jeffrey T. ;
Marano, Alexander ;
Krueger, Andrew ;
Sanders, Donald B. .
MUSCLE & NERVE, 2011, 44 (06) :907-911