title: Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013.
abstract: BACKGROUND
  Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care.
  
  
  METHODS
  We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity.
  
  
  RESULTS
  Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR=3.58) and less likely to have private health insurance (RR=0.58). Adults with active epilepsy were also less likely to be employed (RR=0.53) and much more likely to report being disabled (RR=6.14). They experience greater barriers to health-care access including an inability to afford medication (RR=2.40), mental health care (RR=3.23), eyeglasses (RR=2.36), or dental care (RR=1.98) and are more likely to report transportation as a barrier to health care (RR=5.28).
  
  
  CONCLUSIONS
  These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention.
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Thurman
authors.affiliation: Epilepsy Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: rkobau@cdc.gov.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Kobau
authors.affiliation: Epilepsy Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Yao-Hua
authors.initials: YH
authors.lastname: Luo
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Helmers
authors.affiliation: Epilepsy Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Zack
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D014481:United States; D055815:Young Adult
keywords: Access to care; Epidemiology; Epilepsy; Insurance; Surveillance; United States