Incidence of pediatric narcolepsy diagnosis and management: evidence from claims data

被引:0
|
作者
Tang, Si Hao [1 ]
Min, Jungwon [2 ]
Zhang, Xuemei [2 ]
Uwah, Eberechukwu [2 ]
Griffis, Heather M. [2 ]
Cielo, Christopher M. [2 ,3 ]
Fiks, Alexander G. [2 ,3 ]
Mindell, Jodi A. [2 ,3 ,4 ]
Tapia, Ignacio E. [2 ,3 ,4 ]
Williamson, Ariel A. [2 ,3 ,5 ]
机构
[1] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA
[2] Childrens Hosp Philadelphia, Philadelphia, PA USA
[3] Univ Penn, Perelman Sch Med, Philadelphia, PA USA
[4] Univ Miami, Miller Sch Med, Miami, FL USA
[5] Univ Oregon, Ballmer Inst, Portland, OR USA
来源
JOURNAL OF CLINICAL SLEEP MEDICINE | 2024年 / 20卷 / 07期
关键词
narcolepsy; disparities; insurance; race; pediatric; hypersomnolence; socioeconomic status; SPECIALTY CARE; SLEEP; CHILDREN; DISPARITIES; HEALTH; RACE/ETHNICITY; ADOLESCENTS; INSURANCE; PATTERNS; BARRIERS;
D O I
10.5664/jcsm.11104
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Objectives: The purpose of this study was to characterize the incidence of pediatric narcolepsy diagnosis, subsequent care, and potential sociodemographic disparities in a large US claims database. Methods: Merative MarketScan insurance claims (n = 12,394,902) were used to identify youth (6 -17 years of age) newly diagnosed with narcolepsy ( International Classification of Diseases, 10th revision codes). Narcolepsy diagnosis and care 1 year postdiagnosis included polysomnography with Multiple Sleep Latency Test, pharmacological care, and clinical visits. Potential disparities were examined by insurance coverage and child race and ethnicity (Medicaid-insured only). Results: The incidence of narcolepsy diagnosis was 10:100,000, primarily type 2 (69.9%). Most diagnoses occurred in adolescents with no sex differences, but higher rates in Black vs White youth with Medicaid. Two thirds had a prior sleep disorder diagnosis and 21 -36% had other co-occurring diagnoses. Only half (46.6%) had polysomnography with Multiple Sleep Latency Test (+/- 1 year postdiagnosis). Specialty care (18.9% pulmonary, 26.9% neurology) and behavioral health visits were rare (34.4%), although half were prescribed stimulant medications (51.0%). Medicaid-insured were 86% less likely than commercially insured youth to have any clinical care and 33% less likely to have polysomnography with Multiple Sleep Latency Test. Conclusions: Narcolepsy diagnoses occurred in 0.01% of youth, primarily during adolescence, and at higher rates for Black vs White children with Medicaid. Only half overall had evidence of a diagnostically required polysomnography with Multiple Sleep Latency Test, underscoring potential misdiagnosis. Many patients had co-occurring conditions, but specialty and behavioral health care were limited. Results suggest misdiagnosis, underdiagnosis, and limited narcolepsy treatment, as well as possible disparities. Results highlight the need to identify determinants of evidence-based pediatric narcolepsy diagnosis and management.
引用
收藏
页码:1141 / 1151
页数:11
相关论文
共 50 条
  • [31] The use of antipsychotics and the incidence of diabetes in a geriatric population: Evidence from a claims database
    Kennedy, JS
    Loosbrock, D
    Lage, M
    Hoffmann-Poole, V
    Deberdt, W
    JOURNAL OF CLINICAL PSYCHIATRY, 2002, 63 (11) : 1068 - 1068
  • [32] Evidence That Nurses Need to Participate in Diagnosis: Lessons From Malpractice Claims
    Gleason, Kelly Therese
    Jones, Rebecca
    Rhodes, Christopher
    Greenberg, Penny
    Harkless, Gene
    Goeschel, Chris
    Cahill, Maureen
    Graber, Mark
    JOURNAL OF PATIENT SAFETY, 2021, 17 (08) : E959 - E963
  • [33] Estimates of incidence rates with longitudinal claims data
    Sloan, FA
    Brown, DS
    Carlisle, ES
    Ostermann, J
    Lee, PP
    ARCHIVES OF OPHTHALMOLOGY, 2003, 121 (10) : 1462 - 1468
  • [34] Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments-A Claims Data Analysis
    Zimmermann, Peter
    Kraemer, Sebastian
    Pardey, Nicolas
    Bassler, Stefan
    Stahmeyer, Jona T.
    Lacher, Martin
    Zeidler, Jan
    CHILDREN-BASEL, 2023, 10 (03):
  • [35] Estimating Epilepsy Incidence and Prevalence in the US Pediatric Population Using Nationwide Health Insurance Claims Data
    Kim, Hyunmi
    Thurman, David J.
    Durgin, Tracy
    Faught, Edward
    Helmers, Sandra
    JOURNAL OF CHILD NEUROLOGY, 2016, 31 (06) : 743 - 749
  • [36] ONLINE CME-CERTIFIED CASE CHALLENGES IMPROVE COMPETENCE FOR THE DIAGNOSIS AND MANAGEMENT OF PEDIATRIC NARCOLEPSY AMONG PEDIATRICIANS
    Finnegan, T.
    Murray, C. F.
    Hughes, S.
    Maski, K.
    SLEEP, 2020, 43 : A445 - A445
  • [37] Increased incidence of indeterminate pancreatic cysts and changes of management pattern: Evidence from nationwide data
    Jaewoo Park
    Jinkyeong Park
    Yoon Suk Lee
    Kwangrok Jung
    In Ho Jung
    Jong-Chan Lee
    Jin-Hyeok Hwang
    Jaihwan Kim
    Hepatobiliary&PancreaticDiseasesInternational, 2023, 22 (03) : 294 - 301
  • [38] Increased incidence of indeterminate pancreatic cysts and changes of management pattern: Evidence from nationwide data
    Park, Jaewoo
    Park, Jinkyeong
    Lee, Yoon Suk
    Jung, Kwangrok
    Jung, In Ho
    Lee, Jong-Chan
    Hwang, Jin-Hyeok
    Kim, Jaihwan
    HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL, 2023, 22 (03) : 294 - 301
  • [39] Multiple sclerosis incidence and prevalence in Poland: Data from administrative health claims
    Wnuk, Marcin
    Maluchnik, Michal
    Perwieniec, Jakub
    Podwojcic, Krzysztof
    Szelag, Mateusz
    Walkiewicz, Dorota
    Zakrzewski, Michal
    Kulakowska, Alina
    Brola, Waldemar
    Rejdak, Konrad
    Slowik, Agnieszka
    MULTIPLE SCLEROSIS AND RELATED DISORDERS, 2021, 55
  • [40] Incidence and prevalence of immune thrombocytopenia under the copayment waiver policy for pediatric patients in Korea: Data from the National Health Claims Database
    Park, Sung-Hoon
    Kwak, Sang Gyu
    Kim, Ji Yoon
    LUPUS, 2021, 30 (04) : 655 - 660