Health care utilization of Hispanic/Latino veterans with epilepsy: A national population‐based study

Abstract

AbstractObjectiveHispanic/Latino people with epilepsy are a growing population that has been understudied in clinical epilepsy research. U.S. veterans are at a higher risk of epilepsy due to greater exposures including traumatic brain injury. Hispanic/Latino Veterans with Epilepsy (HL‐VWEs) represent a growing population; however the treatment utilization patterns of this population have been vastly understudied.MethodsHL‐VWE were identified from administrative databases during fiscal year 2019. Variables compared between Hispanic and non‐Hispanic VWEs included demographics, rurality, service era, utilization of clinical services/investigations, and service‐connected injury. Chi‐square and Student's t tests were used for comparisons.ResultsAmong 56 556 VWEs, 3247 (5.7%) were HL. HL‐VWEs were younger (59.2 vs 63.2 years; p < .01) and more commonly urban‐dwelling (81.6% vs 63.2%, p < .01) compared to non–HL‐VWEs. They were also more likely to have served in recent missions such as the Persian Gulf War and post‐ 9/11 wars (p < .01). HL‐VWEs had a higher utilization of all neurology services examined including neurology clinic visits, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, electroencephalography (EEG), epilepsy monitoring, and comprehensive epilepsy care (p < .01 for all). HL‐VWEs were more likely to visit an emergency room or have seizure‐related hospitalizations (p < .01). HL‐VWEs were more likely to have a service‐connected disability greater or equal to 50% (p < .01).SignificanceThis study is one of the largest cohorts examining HL‐VWEs. We found higher utilization of services in neurology, epilepsy, and neuroimaging by HL‐VWEs. HL‐VWE are younger, more commonly urban‐dwelling, and more likely to have served during recent combat periods and have higher amounts of service‐connected disability. Given that the proportion of Hispanic veterans is projected to rise over time, more research is needed to provide the best interventions and mitigate the long‐term impact of epilepsy on this diverse patient group.