Photo Credit: PuiStocker65
Study findings underscore the existence of disparities in geographic access to neurologic care for MS.
Marisa McGinley, DO, presented “Improving Access to MS Care Through Technology” during ACTRIMS Forum 2024, held February 29 to March 2 in West Palm Beach, FL.
For a study published in Neurology—but not necessarily part of Dr. McGinley’s presentation—she and her colleagues “examined disparities in geographic access to neurologists and subspecialty multiple sclerosis (MS) care among various demographic segments of the United States,” according to what they wrote in the paper. The study utilized data from the 2022 CMS Care Compare physician data and MS Center locations defined by the Consortium of Multiple Sclerosis Centers to analyze spatial access across all U.S. census tracts.
Community characteristics at the census tract level— including demographics such as sex, age, race, ethnicity, education, income, insurance status, percentage of individuals with access to a computer, percentage of individuals without access to a vehicle, percentage of individuals with limited English proficiency, and percentages of individuals experiencing hearing, vision, cognitive, and ambulatory difficulties—were obtained from the 2020 American Community Survey 5-year estimates. Rural-urban status was determined using 2010 rural-urban commuting area codes. Logistic and linear regression models were employed to assess access to neurologists or MS Centers within a 60-mile radius and to calculate 60-mile spatial access ratios.
Among 70,858 census tracts, 388 lacked neurologists within a 60-mile radius, while 17,837 lacked MS centers within the same distance. Geographic access to neurologists (as indicated by the spatial access ratio [99% CI]) was notably lower in rural (-80.49%; CI [-81.65 to -79.30]) and micropolitan (-60.50%; CI [-62.40 to -58.51]) areas compared with metropolitan areas. Tracts with a 10% greater percentage of Hispanic individuals (-4.53%; CI [-5.23 to -3.83]), males (-6.76%; CI [-8.96 to -4.5]), uninsured individuals (-7.99%; CI [-9.72 to -6.21]), individuals experiencing hearing difficulty (-40.72%; CI [-44.62 to -36.54]), individuals experiencing vision difficulty (-13.0%; CI [-18.72 to -6.89]), and individuals experiencing ambulatory difficulty (-15.68%; CI [-19.25 to -11.95]) had reduced access to neurologists. Conversely, census tracts with a 10% greater proportion of Black individuals (3.50%; CI [2.93-10.71]), college degree holders (-7.49%; CI [6.67-8.32]), individuals with access to computers (16.57%, CI [13.82-19.40]), individuals without access to a vehicle (9.57%; CI [8.69-10.47]), individuals experiencing cognitive difficulty (25.63%; CI [19.77-31.78]), individuals with limited English proficiency (18.5%; CI [16.30-20.73]), and those aged 10 years or older (8.85%; CI [7.03-10.71]) had higher spatial access to neurologists.
Similar patterns were observed for access to MS centers across various covariates.
For more information regarding ACTRIMS Forum 2024, visit the event website. Return here often for additional MS-focused highlights, abstracts, features and more from ACTRIMS Forum 2024.
