Current opinion in neurology · 2025
Deep brain stimulation access in 2025: geographic, gender, racial, and socioeconomic disparities re-examined.
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Cavaleri Jonathon, Stefanescu Kristen, Lee Darrin, Mason Xenos
Аннотация
PURPOSE OF REVIEW: This review highlights recent studies examining disparities in access to deep brain stimulation (DBS), an effective but resource-intensive therapy for neurological and neuropsychiatric disorders. As DBS indications expand, understanding barriers to equitable provision is increasingly urgent to ensure that all eligible patients can benefit.
RECENT FINDINGS: Emerging literature confirms persistent disparities in DBS utilization based on geography, gender, race, and socioeconomic status. Geographic disparities reflect regional differences in healthcare infrastructure, with limited access in both rural areas of high-income countries and throughout low-income and middle-income nations. Women remain less likely than men to receive DBS for movement disorders, influenced by referral patterns, social support, and patient preference. Racial and ethnic minority patients - particularly Black and Hispanic individuals - consistently receive DBS at lower rates, in part due to reduced referrals. Socioeconomic factors, including insurance status and household income, strongly predict DBS access, favoring privately insured and wealthier patients.
SUMMARY: These findings underscore the need for systemic changes in referral practices, institutional policies, and healthcare funding to reduce structural barriers to DBS. Future research should focus on intersectional factors driving disparities and evaluate targeted interventions to promote equitable access.
RECENT FINDINGS: Emerging literature confirms persistent disparities in DBS utilization based on geography, gender, race, and socioeconomic status. Geographic disparities reflect regional differences in healthcare infrastructure, with limited access in both rural areas of high-income countries and throughout low-income and middle-income nations. Women remain less likely than men to receive DBS for movement disorders, influenced by referral patterns, social support, and patient preference. Racial and ethnic minority patients - particularly Black and Hispanic individuals - consistently receive DBS at lower rates, in part due to reduced referrals. Socioeconomic factors, including insurance status and household income, strongly predict DBS access, favoring privately insured and wealthier patients.
SUMMARY: These findings underscore the need for systemic changes in referral practices, institutional policies, and healthcare funding to reduce structural barriers to DBS. Future research should focus on intersectional factors driving disparities and evaluate targeted interventions to promote equitable access.