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Disparities in Access to DBS Surgery Based on Demographics of Patients with PD Admitted for DBS Surgery in the United States from 2003 to 2013

F.S. Benesh, S. Gupta, V. Sung (Birmingham, AL, USA)

Meeting: 2017 International Congress

Abstract Number: 355

Keywords: Deep brain stimulation (DBS), Parkinsonism

Session Information

Date: Monday, June 5, 2017

Session Title: Surgical Therapy: Parkinson’s Disease

Session Time: 1:45pm-3:15pm

Location: Exhibit Hall C

Objective: To better understand current demographics of DBS use and identify non-medical barriers to its utilization.

Background: Parkinson’s Disease (PD) has seen increasingly more sophisticated methods of management with direct neuromodulation with deep brain stimulation (DBS) being an increasingly common consideration. Given its proven efficacy and widening availability, understanding current trends in patients undergoing DBS implantation will help identify barriers to its utilization.

Methods: Analysis of National Inpatient Sample data from 2003 to 2013 showed a total of 509,951 patients (53.8% male, mean age 77.18 ±9.8, 81.9% Caucasian, 6.4% African American) with a diagnosis of PD (ICD-9 332.0) and, of those patients, 4,632 were admitted for implantation of intracranial neurostimulator leads or DBS (ICD-9 Procedure Code 02.93). These patients were characterized by age, gender, race, insurance source and income quartile. A Pearson’s chi-squared analysis was used for scaled variables and independent scaled t-test for nominal variables. Subjects with incomplete data for one of these variables were excluded.

Results: PD patients admitted for DBS surgery were more often younger (64 versus 77, p<0.001), male (1.1% versus 0.6%, p<0.001), privately insured (3.5% of total, p<0.001) and in the top income quartile of their zip code (1.1%, p<0.001). In regards to racial identity, African Americans were a significantly lower proportion of DBS admission than other reported racial groups (0.2%, p<0.001) [table1].

Conclusions: These results demonstrate that while there is widening use of DBS in PD treatment, there are concerning gaps in its utilization within certain subsets of the population with PD. According to this study, African Americans received significantly fewer DBS procedures than members of other racial groups. This trend likely reflects a combination of access to care, cultural beliefs, socioeconomic status and trust in the medical community. Further studies are needed to better delineate the roles of these factors in order to help improve access to DBS.

To cite this abstract in AMA style:

F.S. Benesh, S. Gupta, V. Sung. Disparities in Access to DBS Surgery Based on Demographics of Patients with PD Admitted for DBS Surgery in the United States from 2003 to 2013 [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/disparities-in-access-to-dbs-surgery-based-on-demographics-of-patients-with-pd-admitted-for-dbs-surgery-in-the-united-states-from-2003-to-2013/. Accessed May 12, 2025.
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