Impact of insurance status on MRI phenotypes in MS

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-09 DOI:10.1016/j.msard.2024.105919

Melissa Lynne Martin , Timothy Robert-Fitzgerald , Matthew K. Schindler , Christopher Perrone , Guy Schultz , Selah Lynch , Nebojsa Mirkovic , Sunil Thomas , Ameena Elahi , Donovan Reid , Tyler M. Moore , Erica B. Baller , Theodore D. Satterthwaite , Matthew Cieslak , Sydney Covitz , Azeez Adebimpe , Abigail Manning , Clyde E. Markowitz , John A. Detre , Amit Bar-Or , Russell T. Shinohara

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引用次数: 0

Abstract

Background

Health insurance in the United States varies in coverage of essential diagnostic tests, therapies, and specialists. Health disparities between privately and publicly insured patients with MS have not been comprehensively assessed. The objective of this study is to evaluate the impact of public versus private insurance on longitudinal brain outcomes in MS.

Methods

Lesional, thalamic, and gray and white matter volumes were extracted from longitudinal MRI of 710 MS patients. Baseline volumes and atrophy rates of lesional, thalamic, and gray and white matter volumes were compared across insurance groups.

Results

After image quality assessment, 376 (284 private / 92 public), 638 (499 / 139), and 331 (250 / 81), patients were in MS lesion, thalamic, gray and white matter analyses respectively. Baseline lesion volume was higher for publicly insured patients but increased at a slightly higher rate in those privately insured (p = 0.01). Baseline gray matter measurements were lower for patients with public insurance, but thalamic (p < 0.01) and gray matter (p < 0.01) atrophy rates were slightly higher in the private insurance group.

Conclusion

Insurance type was associated with lesion, thalamic, and gray matter volumes. The results suggest that patients with public insurance may present with more advanced disease.

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保险状况对多发性硬化症 MRI 表型的影响

背景美国的医疗保险在基本诊断检测、治疗和专科医生的覆盖范围方面存在差异。私人和公共保险的多发性硬化症患者之间的健康差异尚未得到全面评估。本研究的目的是评估公共保险与私人保险对多发性硬化症患者脑部纵向结果的影响。方法从 710 名多发性硬化症患者的纵向核磁共振成像中提取神经节、丘脑、灰质和白质的体积。结果经过图像质量评估后，376 例（284 例私人保险/92 例公共保险）、638 例（499 例/139 例）和 331 例（250 例/81 例）患者分别进行了 MS 病变、丘脑、灰质和白质分析。公共保险患者的基线病变体积较高，但私人保险患者的基线病变体积增加率略高（p = 0.01）。公共保险患者的基线灰质测量值较低，但私人保险组的丘脑（p < 0.01）和灰质（p < 0.01）萎缩率略高于公共保险组。结果表明，公共保险患者的病情可能更严重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.