Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013

- We analyzed 2010, 2013 NHIS data to assess access to care in adults with epilepsy.
- Adults with active epilepsy were more likely to be insured under Medicaid.
- Adults with epilepsy reported greater barriers to health care access.
- Adults with epilepsy were less likely to afford medication, vision, or dental care.
- Adults with epilepsy were more likely to report transportation barriers.

IntroductionCommunity-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.Materials and methodsWe 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.ResultsCompared 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).ConclusionsThese reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention.