Healthcare access and utilization of deep brain stimulation and supplementary care in black and white patients with Parkinson's disease

Abstract

Background

Information comparing healthcare access and utilization between Black and White patients with Parkinson's disease (PD), particularly for deep brain stimulation (DBS) and supplementary care, remains sparse due to the lack of large Black population in a majority of healthcare facilities and limited scope of information in electronic datasets. We hypothesized that Black PD patients are less likely to have implantation for DBS due to many reasons, including ones not explored yet such as a lower likelihood of being assessed for DBS and/or acceptance for DBS when indicated, but more likely to have supplementary care.

Methods

We searched electronic medical records in our tertiary center between January 1, 2006 and October 1, 2021, followed by chart reviewing and extracting demographics, socioeconomic status, comorbidities, and healthcare access and utilization, including medications, DBS and supplementary care. Of 2827 patients in records, 1211 were assessed by movement neurologists here, who verified the diagnosis in 882 of them (72.8 %). We included 846 patients (95.9 %) (Black/White 255/591) with needed information for analysis.

Results

Compared to White patients, Black patients lacked male predominance, had lower socioeconomic status, more comorbidities, and frequent care in emergency/inpatient settings. There was no difference in overall medication use, but Black patients were less likely to have implantation and evaluation for DBS, and to accept DBS when indicated, and more likely to have supplementary care.

Conclusions

Black patients are less likely to have DBS implantation, evaluation, and acceptance but more likely to have supplementary care compared to White patients. These new findings could help improve healthcare.