The following is a summary of “Disparities in Teleneurology Use in Medicaid Beneficiaries With Epilepsy by Practice Setting: Promoting Health Equity in Academic Centers,” published in the April 2024 issue of Neurology by Gotlieb et al.

Researchers conducted a retrospective study investigating whether epilepsy patients receiving care at Medicaid-only clinics within academic centers use telehealth less than those treated in integrated faculty practices.

They analyzed structured data from the Mount Sinai Health System electronic medical record (January 2003 to August 2021). People of all ages diagnosed with epilepsy and under the care of an epileptologist after January 3, 2018, were identified using a validated ICD-9-CM/10-CM coded case definition. Associations between practice setting and telehealth utilization were assessed using multivariable logistic regression, capturing changes in neurologic care delivery post-coronavirus disease 2019.

The results showed that 4,586 people with epilepsy were seen by an epileptologist, including 387 Medicaid beneficiaries in the Medicaid outpatient clinic, 723 Medicaid beneficiaries in the faculty practice after integration, and 3,476 non-Medicaid beneficiaries. The latter group was significantly older (average age 40 years) compared to Medicaid beneficiaries (average age 29 and 28.5 years, respectively) (P<0.0001). Medicaid beneficiaries were more likely to have drug-resistant epilepsy (DRE) (51.94% in the Medicaid-only outpatient clinic, 41.63% in the faculty practice, and 37.2% in non-Medicaid beneficiaries) (P<0.0001). Medicaid outpatient clinic patients were less likely to have telehealth visits (81.65% had no telehealth visits) compared to 71.78% of Medicaid beneficiaries in the faculty practice and 70.89% of non-Medicaid beneficiaries (P<0.0001). In an adjusted logistic regression analysis, Medicaid beneficiaries had lower odds (0.61; 95% CI 0.46–0.81) of using teleneurology compared with all patients seen in faculty practice (P=0.0005).

Investigators concluded that epilepsy patients at integrated faculty practices within academic centers had higher rates of telehealth use compared to those treated in Medicaid-only clinics, regardless of insurance type.

Source: neurology.org/doi/10.1212/WNL.0000000000209348