Increased healthcare utilization in the year before multiple sclerosis diagnosis

Mult Scler Relat Disord. 2024 Mar:83:105438. doi: 10.1016/j.msard.2024.105438. Epub 2024 Jan 16.

Abstract

Background: Studies have suggested possible multiple sclerosis (MS) prodrome with non-routine healthcare utilization as an indicator. The objective of this project was to compare utilization in the four years (years -1, -2, -3, -4) before clinically definite diagnosis and examine demographic associations.

Methods: i2B2 database search at the Medical College of Wisconsin Comprehensive MS center yielded 613 patients between 07/01/2018 and 07/01/2022. Patients with established MS diagnosis, MS mimicker diagnoses, and pediatric-onset MS were excluded; 108 met the criteria for adult patients ≥ 18 years of age newly diagnosed with clinically definite MS after manual chart review. Utilization score for each of the four years before diagnosis was calculated; demographic variables were also collected. Adjusted repeated measures mixed model and Pearson correlation analysis were performed; P value was set at <0.05 for statistical significance.

Results: Utilization was greatest for year -1 compared to years -2, -3, and -4 after demographics adjustment (p < 0.001). Utilization was greater (p < 0.05) for older age and unmarried, patients.

Conclusions: Utilization increased a year before formal MS diagnosis, suggestive of prodromal presentation.

Keywords: Healthcare utilization; Multiple sclerosis; Neurology; Prodrome; Retrospective chart review; Socioeconomic determinants of health.

MeSH terms

  • Adult
  • Child
  • Delivery of Health Care
  • Hospitals
  • Humans
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / epidemiology
  • Multiple Sclerosis* / therapy
  • Patient Acceptance of Health Care
  • Research Design