Racial/ethnic and socioeconomic disparities contribute to frequent emergency department visits for seizures, according to a study published online July 5 in Epilepsia.

Brad K. Kamitaki, M.D., from Rutgers-Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues conducted a retrospective cohort study of adult patients presenting to the emergency department in four U.S. states with a primary diagnosis of seizure or epilepsy to examine whether people who were uninsured or had public health insurance, belonged to minoritized racial/ethnic groups, or resided in low-income zip codes were more likely to have frequent emergency department visits.

A total of 200,962 patients were identified who visited the emergency department for seizure/epilepsy; of these, 14.7% presented two times during the study period. The researchers found that individuals with Medicare, Medicaid, or no insurance had increased odds of high emergency department use compared with those with private insurance (adjusted odds ratios, 1.90, 2.01, and 1.55, respectively).

Compared with white patients, Black patients had increased odds of frequent emergency department visits (adjusted odds ratio, 1.60). For Black patients with Medicare and Medicaid versus private insurance, however, these disparities were attenuated.

Other racial/ethnic groups did not have high emergency department use. Compared with those in the highest income quartile, patients living in low-income zip codes (0 to 25th percentile of median household income) were more likely to be in the high emergency department visit group (adjusted odds ratio, 1.65).

“Eliminating deeply rooted factors such as poverty, health care costs, and systemic racism requires comprehensive, multisectoral approaches far beyond the scope of health care providers alone,” the authors write. “Even so, clinicians and researchers can play a crucial role by advocating for their patients, engaging policymakers, and providing resources and evidence-based strategies to address these systemic challenges.”

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