Addressing Specific Social Determinants of Health in Epilepsy: Joseph Sirven, MD


The professor of neurology at Mayo Clinic detailed ways to address social determinants of health and the gaps in care for patients with epilepsy.

"The old stigma is that this is an okay thing to wait on, and it will play out and the person will not get treated. That’s what we ended up finding. The more you don’t touch the medical system and go the traditional route, you don’t typically get managed the way you should.”

In an attempt to examine the underlying cause and extent of treatment delays for individuals with epilepsy, Joseph Sirven, MD, and colleagues gathered data on different social determinants of health using Arizona Medicaid claims records from 2015 to 2019. Along with social determinants of health, the dataset also included information on patient demographics and initial diagnosis setting, all by using Z-codes.

The results showed that patients diagnosed in inpatient settings are 2 times more likely to be treated within 30 days compared to diagnosis in an office setting. Non-traditional settings of diagnosis led to 5.9 times more likelihood of being untreated than an office setting. The most significant variables for treatment delays were care setting, age, race, marital status, homelessness, and poverty.

Sirven, a professor of neurology at Mayo Clinic, claims that the typical guidelines and criteria within an inpatient setting allow for better rates of diagnosis, whereas those in a non-traditional route may not receive as much attention or full treatment. He sat down for a discussion on the reasons behind these disparities and provided thoughts on whether these significant variables are correctable or are just a part of natural human life.

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Sirven J, Sprout G, Speer M, Simic G, Reddy S. The role of social determinants in epilepsy treatment delays for Arizonans on Medicaid. Presented at American Academy of Neurology Annual Meeting; April 17-22. Abstract P11.008
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