Demographic and geographic variations in the access time of pediatric patients presenting with staring spells

• Published in: Epilepsy & behavior Vol. 145; p. 109299
• Main Authors: Goenka, Ajay, Fonseca, Laura D., Kumar, Gogi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2023
• Subjects: Access time; Nonepileptic paroxysmal events; Staring spells; Symptom onset; Access time; Staring spells; Symptom onset; Nonepileptic paroxysmal events
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2023.109299

•Staring spells are defined as behavioral inattention and ‘daydreaming’•Access time is a lapse in time from symptom onset to seeking neurological care.•We assessed the social variations in access time in children with staring spells.•Access time varied based on age group, insurance, race/ethnicity, and county.•Populations in higher per capita personal income had significant less access time.
To assess the demographic and geographic variations in access time – defined as years between the date of symptom onset and initial date of neurological care – in pediatric patients presenting with staring spells.
We conducted a secondary analysis of a retrospective chart review study from 2011 to 2021. A total of 1,353 staring spell patients, aged 0 to 17.9 years, were analyzed for age, sex, race/ethnicity, insurance, county, average county annual per capita personal income, and access time.
Patients aged 0–2.9 years had the shortest median access time of 0.3 years, compared to 1.2 years in patients aged 3–12.9 years and 1.0 year in patients aged 13–17.9 years. Statistically significant differences were seen based on race/ethnicity and insurance with White patients having shorter access time of 0.5 years compared to Black patients with 1.0 year and self-pay patients having the shortest access time of 0.4 years compared to patients with private insurance (0.7 years). Warren County had the largest annual per capita personal income of $65,855 and access time of 0.5 years compared to Preble county with the least annual per capita personal income of $45,016 and access time of 1.1 years.
Demographic parameters of age, race/ethnicity, insurance, and annual county per capita personal income appeared to be associated with access time to initial neurological care in patients with staring spells. These associations need to be investigated further to ensure timely access to neurological care and to ensure equity in health care.