Geospatial Analysis of Persons with Movement Disorders Living in Underserved Regions.
Movement Disorders
geography
spatial analysis
underserved
Journal
Tremor and other hyperkinetic movements (New York, N.Y.)
ISSN: 2160-8288
Titre abrégé: Tremor Other Hyperkinet Mov (N Y)
Pays: England
ID NLM: 101569493
Informations de publication
Date de publication:
2021
2021
Historique:
received:
16
05
2021
accepted:
23
07
2021
entrez:
13
9
2021
pubmed:
14
9
2021
medline:
15
12
2021
Statut:
epublish
Résumé
Movement disorders persons from underserved areas have increased barriers to access tertiary care. There is currently limited data on the geographic and demographic profile of movement disorders persons from underserved areas. A retrospective chart review of the geographic and demographic profile of consecutive cases seen between 2002-2017 at the University of Florida Norman Fixel Institute for Neurological Diseases (UF-NFIND) was performed. Information collected included age, sex, diagnosis, zip code, treatment received, and insurance information. The distances between each person's home residence and the nearest movement disorders center of excellence (MDC) as well as the distance to the UF-NFIND were calculated using ArcGIS 10.3. A total of 5.2% (355/6867) of the sample population were identified as a Medicaid/self-pay population and classified as underserved. The most common diagnoses were tic disorder (19.2%), dystonia (18.3%), and Parkinson's disease (14.3%). In underserved persons, the median distances from their homes to the UF-NFIND (82.19 [45.79-176.93] km) vs. their nearest MDC (63.34 [26.91-121.43] km) were significantly different ( Underserved persons in our study travelled further to receive subspecialty care at UF-NFIND than closer MDCs. Potential reasons for underutilization of closer care could possibly include research opportunities, availability of specific treatments or procedures, insurance restrictions, and limited specialist availability. Despite this observation, underserved persons were underrepresented at our institution compared to the proportion of Medicaid/uninsured patients in Florida. Our results highlight the need for increased awareness of care options for underserved movement disorders populations.
Sections du résumé
Background
Movement disorders persons from underserved areas have increased barriers to access tertiary care. There is currently limited data on the geographic and demographic profile of movement disorders persons from underserved areas.
Methods
A retrospective chart review of the geographic and demographic profile of consecutive cases seen between 2002-2017 at the University of Florida Norman Fixel Institute for Neurological Diseases (UF-NFIND) was performed. Information collected included age, sex, diagnosis, zip code, treatment received, and insurance information. The distances between each person's home residence and the nearest movement disorders center of excellence (MDC) as well as the distance to the UF-NFIND were calculated using ArcGIS 10.3.
Results
A total of 5.2% (355/6867) of the sample population were identified as a Medicaid/self-pay population and classified as underserved. The most common diagnoses were tic disorder (19.2%), dystonia (18.3%), and Parkinson's disease (14.3%). In underserved persons, the median distances from their homes to the UF-NFIND (82.19 [45.79-176.93] km) vs. their nearest MDC (63.34 [26.91-121.43] km) were significantly different (
Discussion
Underserved persons in our study travelled further to receive subspecialty care at UF-NFIND than closer MDCs. Potential reasons for underutilization of closer care could possibly include research opportunities, availability of specific treatments or procedures, insurance restrictions, and limited specialist availability. Despite this observation, underserved persons were underrepresented at our institution compared to the proportion of Medicaid/uninsured patients in Florida. Our results highlight the need for increased awareness of care options for underserved movement disorders populations.
Identifiants
pubmed: 34513276
doi: 10.5334/tohm.635
pmc: PMC8396113
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
34Informations de copyright
Copyright: © 2021 The Author(s).
Déclaration de conflit d'intérêts
The authors have no competing interests to declare.
Références
Cureus. 2018 Oct 22;10(10):e3474
pubmed: 30648026
Neurology. 2016 Apr 12;86(15):1400-1407
pubmed: 26865518
Nat Rev Neurol. 2018 May;14(5):285-297
pubmed: 29623949
J Community Health. 2013 Oct;38(5):976-93
pubmed: 23543372
Neurology. 2017 Sep 12;89(11):1152-1161
pubmed: 28814455
Neurotherapeutics. 2014 Jan;11(1):128-38
pubmed: 24142589
Continuum (Minneap Minn). 2010 Feb;16(1 Movement Disorders):13-48
pubmed: 22810179
Mov Disord. 2012 Dec;27(14):1789-96
pubmed: 23114997
Mov Disord. 2018 Aug;33(8):1248-1266
pubmed: 29570866
Neurology. 2017 Jun 13;88(24):2268-2275
pubmed: 28515272
Neurology. 2019 May 7;92(19):896-906
pubmed: 31061208
Mov Disord. 2010 Apr 15;25(5):534-41
pubmed: 20175185
Neurology. 2007 Jan 30;68(5):326-37
pubmed: 17261678
Toxins (Basel). 2013 Feb 04;5(2):249-66
pubmed: 23381141
Mov Disord Clin Pract. 2020 Apr 16;7(4):355-356
pubmed: 32373650
J Am Geriatr Soc. 2018 Jul;66(6):1226-1232
pubmed: 29608779
Parkinsons Dis. 2015;2015:639494
pubmed: 26078912
Psychother Psychosom. 2021;90(1):64-66
pubmed: 32498070
J Rural Health. 2014 Fall;30(4):412-21
pubmed: 24702698
Am J Manag Care. 2019 Mar 1;25(3):e83-e87
pubmed: 30875176