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Published on: March 27, 2012
Demographic and geographic variations in the access time of pediatric patients presenting with staring spells
Ajay Goenka1, Laura D Fonseca2, Gogi Kumar1
1Department of Neurology, Dayton Children's Hospital, Dayton, OH, USA; Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
Insights
Pediatric patients with staring spells experience varied access times to neurological care. Age, race, insurance, and income influence these delays, highlighting the need for equitable healthcare access.
Area of Science:
- Pediatric Neurology
- Healthcare Access Disparities
- Child Health Outcomes
Background:
- Staring spells in children can indicate underlying neurological conditions requiring timely specialist evaluation.
- Access to neurological care is crucial for accurate diagnosis and management of pediatric neurological disorders.
- Variations in healthcare access can lead to delayed diagnosis and treatment, impacting child health outcomes.
Purpose of the Study:
- To investigate demographic and geographic factors influencing the time to initial neurological care for pediatric patients with staring spells.
- To identify disparities in access time based on patient age, race/ethnicity, insurance status, and socioeconomic factors.
- To inform strategies for improving equitable access to pediatric neurological services.
Main Methods:
- Retrospective chart review of 1,353 pediatric patients (0-17.9 years) diagnosed with staring spells between 2011 and 2021.
- Analysis of patient demographics (age, sex, race/ethnicity, insurance) and geographic data (county income).
- Calculation of access time, defined as the interval between symptom onset and initial neurological care.
Main Results:
- Younger children (0-2.9 years) had the shortest median access time (0.3 years).
- Significant disparities observed by race/ethnicity (White: 0.5 years vs. Black: 1.0 year) and insurance status (self-pay: 0.4 years vs. private insurance: 0.7 years).
- Higher county per capita income correlated with shorter access times (e.g., Warren County: $65,855 income, 0.5 years access vs. Preble County: $45,016 income, 1.1 years access).
Conclusions:
- Age, race/ethnicity, insurance, and county income are associated with access time to neurological care for pediatric staring spells.
- These findings underscore significant inequities in healthcare access for children with neurological conditions.
- Further research and targeted interventions are necessary to ensure timely and equitable neurological care for all children.
Objective:
To assess the demographic and geographic variations in access time - defined as years between the date of symptom onset and initial date of neurological care - in pediatric patients presenting with staring spells.
Materials And Methods:
We conducted a secondary analysis of a retrospective chart review study from 2011 to 2021. A total of 1,353 staring spell patients, aged 0 to 17.9 years, were analyzed for age, sex, race/ethnicity, insurance, county, average county annual per capita personal income, and access time.
Results:
Patients aged 0-2.9 years had the shortest median access time of 0.3 years, compared to 1.2 years in patients aged 3-12.9 years and 1.0 year in patients aged 13-17.9 years. Statistically significant differences were seen based on race/ethnicity and insurance with White patients having shorter access time of 0.5 years compared to Black patients with 1.0 year and self-pay patients having the shortest access time of 0.4 years compared to patients with private insurance (0.7 years). Warren County had the largest annual per capita personal income of $65,855 and access time of 0.5 years compared to Preble county with the least annual per capita personal income of $45,016 and access time of 1.1 years.
Conclusion:
Demographic parameters of age, race/ethnicity, insurance, and annual county per capita personal income appeared to be associated with access time to initial neurological care in patients with staring spells. These associations need to be investigated further to ensure timely access to neurological care and to ensure equity in health care.
