Health Disparities in the Neurosurgical Care of Patients with Trigeminal Neuralgia.
Publication/Presentation Date
9-1-2024
Abstract
BACKGROUND: There has been limited investigation into how social determinants of health impact treatment outcomes in patients with trigeminal neuralgia (TN). We aimed to investigate how social determinants of health may alter the course of clinical care for patients with TN.
METHODS: The electronic medical record was queried for patients with a diagnosis of TN comanaged by neurosurgeons and other facial pain specialists at our medical center. Area Deprivation Index served as a proxy for socioeconomic status (SES). Multivariable linear regression models were performed using RStudio to assess the impact of social determinants on the time to neurosurgical referral and surgical intervention.
RESULTS: A total of 229 patients (mean age 50 years, 74% female) were included. Of these, 135 (60%) patients underwent a neurosurgical procedure after referral, the most common being microvascular decompression (n = 84, 62%) (Table 1). Most of the patients were white (76.3%) and insured by Medicare (51.8%), followed by private insurance (38.6%). Age and sex were significant predictors of time to neurosurgical referral after symptom onset, as older patients (P < 0.01, Figure 3) and females (P = 0.02) tended to have a greater delay between symptom onset and specialist referral. Race, SES, and insurance status were not significantly associated with time-to-referral or time-to-treatment.
CONCLUSION: This study found that older and female patients with TN had a longer time from symptom onset to specialist referral. Based on these data, there is no association between race, SES, and insurance status with time-to-referral or time-to-treatment in patients with TN.
Volume
189
First Page
294
Last Page
294
ISSN
1878-8769
Published In/Presented At
Reyes, M., Shelley, I., Vinjamuri, S., Kelly, P., Bingaman, A., Kayne, A., Bray, D. P., & Evans, J. J. (2024). Health Disparities in the Neurosurgical Care of Patients with Trigeminal Neuralgia. World neurosurgery, 189, e294–e299. https://doi.org/10.1016/j.wneu.2024.06.040
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
38871283
Department(s)
Administration and Leadership
Document Type
Article