To identify disparities in rates of elective video-EEG monitoring admissions by race/ethnicity and insurance status in New Jersey.

From the New Jersey Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) between 2014-2016, we identified elective admissions for video-EEG monitoring with an admitting diagnosis ICD-9 or ICD-10 code for seizure (780.3; R56) or epilepsy (345; G40). Using data from the NJ Census and the American Community Survey, we determined elective video-EEG admission rates stratified by race/ethnicity and primary payer.

There were 2429 adult (age > 18) admissions for elective video-EEG monitoring for seizure or epilepsy between 2014-2016. Admitted patients were 41.1 years old (SD 16.9, range 18-94), and 57% were women. The mean length of stay was 3.6 days (SD 2.5).

Admission rates were lowest among uninsured patients (0.02/1000 person years [py]). For Medicare patients, Blacks had the highest rates of admission (0.43/1000 py), followed by Hispanic (0.23/1000 py), Whites (0.19/1000 py), and lowest among Asian/Pacific Islanders (API) (0.04/1000 py). For Medicaid patients, Whites were the highest utilizers (0.20/1000 py), then Blacks (0.17/1000 py), with similar rates among Hispanic (0.09/1000 py) and API (0.09/1000 py). Lastly, rates were relatively lower for those with private insurance (Blacks 0.11/1000 py, Whites 0.07/1000 py, Hispanic 0.07/1000 py, API 0.02/1000 py).

Uninsured patients, faced with the high cost of hospital admission, may require creative strategies for managing drug-resistant epilepsy. Lowest utilization rates seen with Asian/Pacific Islanders across all insurance types could be related to cultural stigmas surrounding epilepsy, but needs to be explored in more definitive studies.