title: Do older adults have equitable access to specialist epilepsy services?
abstract: The number of older patients with epilepsy has been increasing steadily. We assessed whether older adults with epilepsy have equitable access to our regional specialist service, designed to serve all patients regardless of age or their ability to pay. We examined the records of 846 adults under the current care of our epilepsy service and used data from a previous epidemiologic study to estimate the proportion of local patients accessing our service in different age groups. Whereas 43.7% of adults younger than age 20 were using the specialist service, only 2.3% of people with epilepsy who were 85 and older had been referred. The results raise the possibility of inadvertent age discrimination, putting older adults with seizures at greater risk for misdiagnoses and suboptimal management.
authors.affiliation: Academic Neurology Unit, University of Sheffield, Sheffield, United Kingdom. markus.reuber@sth.nhs.uk
authors.forename: Markus
authors.initials: M
authors.lastname: Reuber
authors.forename: Pravin
authors.initials: P
authors.lastname: Torane
authors.forename: Carina
authors.initials: C
authors.lastname: Mack
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000451:nursing / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013222:State Medicine / Q000706:statistics & numerical data*; D006113:United Kingdom; D055815:Young Adult