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Socioeconomic outcome and access to care in adults with epilepsy in Sweden: A nationwide cohort study.

Artikel i vetenskaplig tidskrift
Författare Klara Andersson
Anneli Ozanne
Anna Edelvik Tranberg
John Chaplin
Kristian Bolin
Kristina Malmgren
Johan Zelano
Publicerad i Seizure
Volym 74
Sidor 71-76
ISSN 1532-2688
Publiceringsår 2020
Publicerad vid Institutionen för neurovetenskap och fysiologi
Centrum för hälsoekonomi (CHEGU)
Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Institutionen för vårdvetenskap och hälsa
Sidor 71-76
Språk en
Länkar dx.doi.org/10.1016/j.seizure.2019.1...
Ämneskategorier Neurovetenskap, Pediatrik

Sammanfattning

Epilepsy has well-documented associations with low income and low education levels, but the impact of a patient's socioeconomic standing (SES) on the effects of epilepsy have been less studied.We performed a register-based cross-sectional study and asked if SES was associated with more severe epilepsy or limited access to care in Sweden, where health care is universal, and if socioeconomic outcomes (employment and income) differed for persons with epilepsy (PWE) with different levels of educational attainment. The study cohort consisted of all adult patients with an epilepsy diagnosis in the Swedish patient register in 2000-2015 (n = 126,406) and controls (n = 379,131) matched for age, gender, and place of birth.Somatic and psychiatric comorbidities were more common in PWE, while education and income levels were lower. Among PWE, hospitalizations were more common in persons with lower income or education. Having at least one prescription written by a neurologist in the study period was more common in the high-income and high-education groups. Finally, although low educational attainment was associated with low levels of income and inversely associated with employment in both persons with epilepsy and controls, regression analyses demonstrated that these associations were much more noticeable in cases than controls.We conclude that both the severity and consequences of epilepsy are greater in persons of low SES, even in a country with universal health care. This indicates that universal access may not be sufficient to mitigate socioeconomic inequity in epilepsy.

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