Evidence map›Paper›PMID 28515272›Full record

ArticleNeurology2017

Racial disparities in neurologic health care access and utilization in the United States.

Altaf Saadi, David U Himmelstein, Steffie Woolhandler, Nicte I Mejia

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 158 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
158citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

158 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  9. The Ecology of Care in Parkinson's Disease.Movement disorders clinical practice · 2026
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98 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Altaf SaadiFrom Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston. asaadi@partners.org.
David U HimmelsteinFrom Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston.
Steffie WoolhandlerFrom Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston.
Nicte I MejiaFrom Partners Neurology Residency Program (A.S.), Massachusetts General Hospital and Brigham and Woman's Hospital; Harvard Medical School (A.S., D.U.H., S.W., N.I.M.), Boston, MA; City University of New York at Hunter College (D.U.H., S.W.), New York; and Massachusetts General Hospital (N.I.M.), Boston.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate racial and ethnic differences in the utilization of neurologic care across a wide range of neurologic conditions in the United States.

methodsWe analyzed nationally representative data from the 2006-2013 Medical Expenditure Panel Survey (MEPS), including information on demographics, patient-reported health conditions, neurology visit rates, and costs. Using diagnostic codes, we identified persons with any self-identified neurologic disorder except back pain, as well as 5 subgroups (Parkinson disease, multiple sclerosis, headache, cerebrovascular disease, and epilepsy). To assess disparities in neurologic care utilization, we performed logistic regression analyses of outpatient department neurologic care visit rates and expenditures for each racial ethnic group controlling for age, sex, health status, socioeconomic characteristics, and geographic region of care.

resultsOf the 279,103 MEPS respondents, 16,936 (6%) self-reported a neurologic condition; 5,890 (2%) received a total of 13,685 outpatient neurology visits. Black participants were nearly 30% less likely to see an outpatient neurologist (odds ratio [OR] 0.72, confidence interval [CI] 0.64-0.81) relative to their white counterparts, even after adjustment for demographic, insurance, and health status differences. Hispanic participants were 40% less likely to see an outpatient neurologist (OR 0.61, CI 0.54-0.69). Among participants with known neurologic conditions, blacks were more likely to be cared for in the emergency department, to have more hospital stays, and to have higher per capita inpatient expenditures than their white counterparts.

conclusionsOur findings highlight racial and ethnic inequalities in the utilization of neurologic care in the United States.

Indexed as

Health Services AccessibilityAdolescentAdultAgedFemaleHealthcare DisparitiesHumansMaleMiddle AgedNervous System DiseasesPatient Acceptance of Health CareSelf ReportSocioeconomic FactorsUnited StatesYoung Adult

Identifiers

PMID28515272
PMCPMC5567325

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.