title: Racial differences in Emergency Department visits for seizures.
abstract: OBJECTIVE
  Seizures are a common reason for visiting the Emergency Department (ED). There is a growing body of literature highlighting disparities in seizure care related to race and ethnicity. Our goal was to identify racial and clinical characteristics of patients presenting to the ED with seizures and to determine factors associated with repeat ED visits for seizure.
  
  
  METHODS
  This was a retrospective study evaluating patients presenting with seizure as the primary reason for their ED visit between 01/01/2008 and 12/31/2008. Clinical data were collected from the electronic medical record (EMR) and compared between black and white patients and between patients with single and repeat ED seizure visits. Statistically significant variables were introduced in a logistic regression analysis with repeat ED visits as outcome.
  
  
  RESULTS
  Of 38, 879 ED visits, 559 recorded 'seizure' as the primary reason for the visit. Compared to white patients (N=266), black patients (N=102) were more likely to have non-private insurance (p=0.005), less likely to have evidence of regular ambulatory care (p=0.02) and were more likely to have multiple visits within the calendar year (p=0.005). Black patient visits were more likely to have missed or ran out of antiepileptic drugs (AED) as the precipitant for their ED visit (p<0.001).
  
  
  CONCLUSIONS
  Clinical factors differed between black and white patients presenting to the ED for seizure care. Black patients were more likely to have multiple seizure visits to the ED when compared to white patients. This may suggest a disparity in access to care related to race between these two groups.
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, United States. Electronic address: TFantaneanu@partners.org.
authors.forename: Tadeu A
authors.initials: TA
authors.lastname: Fantaneanu
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, United States. Electronic address: Hurwitz@hms.harvard.edu.
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, United States. Electronic address: katherinevanmeurs@gmail.com.
authors.forename: Katherine
authors.initials: K
authors.lastname: van Meurs
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, United States. Electronic address: NLlewellyn@partners.org.
authors.forename: Nichelle
authors.initials: N
authors.lastname: Llewellyn
authors.affiliation: Department of Emergency Medicine, Harvard Medical School, Brigham and Women's Hospital, United States. Electronic address: KOLaughlin@partners.org.
authors.forename: Kelli N
authors.initials: KN
authors.lastname: O'Laughlin
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, United States. Electronic address: bdworetzky@partners.org.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Dworetzky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D001900:Boston / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American