Abstract Details

Title Socioeconomic Disparities in Adults with Encephalitis

Topic Autoimmune Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 8-012

Objective To identify differences in health characteristics and clinical outcomes among encephalitis patients of different insurance plans and income levels.

Background

Encephalitis is an inflammation of the brain caused largely by infectious or autoimmune etiologies. To date, the role of socioeconomic factors in the clinical characteristics and outcomes of patients with encephalitis has not been studied.

Design/Methods We conducted a retrospective cohort study using electronic health records from Greater Houston and Baltimore areas between 2005-2022. Insurance status was defined as public, private, both, or none. Median household income was determined by the U.S. Census Bureau using patients’ zip codes.

Results Of 647 patients, 569 (87.9%) had documented health insurance, with 188 (33%) on public plans, 259 (45.5%) on private, 59 (10.4%) on both, and 63 (11.1%) uninsured. Patients with both private and public insurance (dual coverage) were significantly more likely to be >60 years old and have a Charlson Comorbidity Index>2 (p<.001). Ethnic minority patients were more likely to be uninsured or on public insurance (p<.001). A greater percentage of patients with no insurance or with public insurance were immunocompromised and HIV-positive compared to those with private or dual coverage (p=.005, immune-status; p<.001, HIV-status). Lack of insurance and public insurance were associated with infectious etiology (p=.012), while dual coverage was associated with autoimmune etiology (p=.002). Lower median household income was significantly associated with being an ethnic minority, immunocompromised, HIV-positive, and an infectious etiology. There were no significant differences between insurance groups nor income levels for ICU admission, mortality, and Glasgow Outcome Score<4.

Conclusions

Insurance status and income level impact underlying health conditions, but these disparities do not appear to translate into significant differences for patients with encephalitis once in the acute care setting. Our study demonstrates that patients receive similar, if not equitable care during hospitalization, mitigating the effects of socioeconomic status on clinical outcomes.

Authors/Disclosures
Sienna Wu PRESENTER	Ms. Wu has nothing to disclose.
Rodrigo Hasbun	Rodrigo Hasbun has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biomeriaux. The institution of Rodrigo Hasbun has received research support from Biomeriaux.
Ralph Habis, MD (Johns Hopkins School of Medicine)	Dr. Habis has nothing to disclose.
Ivany V. Patel, BA	Ms. Patel has nothing to disclose.
Jordan Benderoth	Miss Benderoth has nothing to disclose.
Arun Venkatesan, MD, PhD (Johns Hopkins Hospital)	Dr. Venkatesan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Pharmaceuticals. The institution of Dr. Venkatesan has received research support from NIH. The institution of Dr. Venkatesan has received research support from U.S. DOD.
John Probasco, MD, FAAN (The Johns Hopkins Hospital)	Dr. Probasco has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Clinician. The institution of Dr. Probasco has received research support from Roche/Genentech.
Laya Rao (Villas at Hermann Park)	Ms. Rao has nothing to disclose.
Rajesh K. Gupta, MBBS (UTHealth)	Dr. Gupta has nothing to disclose.

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