New research has found that while the prevalence of neurological conditions such as dementia, stroke, Parkinson’s disease and multiple sclerosis (MS) is consistent across the United States, the distribution of neurologists is not, and people in more rural areas are less likely to receive special care. for certain neurological conditions. The study, funded by the American Academy of Neurology, was published in the online edition of the journal. December 23, 2020 Neurology, a medical journal of the American Academy of Neurology.
“Neurologists in the United States are not evenly distributed, which affects whether patients can visit a neurologist because of certain conditions such as dementia and stroke,” said study author Brian C. Callaghan, Ph.D. Med., From the University of Michigan at Ann Arbor and a member of the American Academy of Neurology. “Our research found that some areas in the country have up to four times more neurologists than areas with the lowest service, and those differences mean some people don’t have access to neurologists who are specifically trained to treat brain diseases.”
However, Callaghan noted that the proportion of people receiving special care from neurologists in more rural areas varies by condition. People with specific, rarer conditions such as Parkinson’s disease and multiple sclerosis were as likely to visit a neurologist in more rural areas as in more urban ones, while people with less specific neurological symptoms that are more common, such as dementia, pain, dizziness or vertigo, or disorders sleeping, are more likely to visit a neurologist in more urban areas than in more rural ones.
During the study, researchers reviewed one-year data for 20% of people enrolled in Medicare and identified 2.1 million people with at least one office visit due to a neurological condition.
The researchers recorded how many times people visited a neurologist’s office during that year and compared it to the number of office visits to other health care providers due to a neurological condition.
The researchers identified a total of 13,627 neurologists working in the regions where study participants lived.
The researchers found that areas with the fewest neurologists have an average of 10 neurologists for every 100,000 people, while areas with the most neurologists have an average of 43 neurologists for every 100,000 people.
The researchers also found that the prevalence of neurological conditions did not differ between regions. Nearly one-third of people had at least one office visit due to a neurological condition.
Overall, 24% of people with a neurological condition were examined by a neurologist. In more rural areas this number was 21%, compared to 27% in the areas with the most neurologists. Most of that difference was made up of people with dementia, back pain and stroke. As for dementia, 38% of people in more rural areas visited a neurologist, compared to 47% in urban areas. Because of stroke, 21% of people in more rural areas saw a neurologist, compared to 31% in urban areas.
On the other hand, more than 80% of people with Parkinson’s disease received care from a neurologist, no matter where they lived. The numbers were similar in multiple sclerosis.
“It’s important that all people have access to the best neurological care,” said James C. Stevens, Ph.D. Med., FAAN, President of the American Academy of Neurology. “It’s not surprising that more neurologists tend to work and live in urban areas, but this study highlights the need to ensure that rural areas also have a supply of neurologists to meet demand. One way to give people greater access to neurological care is telemedicine. which was used successfully during the COVID-19 pandemic. Remote visits to the office via computer or telephone are one way to extend the neurological service to people in poor areas. “
A limitation of the study is that the researchers looked at neurological visits only for people who cover Medicare, so the results may not be applicable to younger people with private insurance.
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Provided by the American Academy of Neurology
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