OBJECTIVES: To examine the baseline characteristics and hospital utilization rates in Asian American and White American patients with Multiple Sclerosis (MS) in Hawaii.

METHODS: This retrospective study examined hospital discharge data (all payer; all visits) from 23 civilian hospitals in Hawaii from 2009 to 2015 among patients with MS as the primary or secondary diagnosis (N=776; 987 inpatient admissions; 1,571 emergency department [ED] visits). Patients’ race was self-identified according to the categories defined by the Office of Management and Budget. Racial/ethnic differences were examined for three groups (whites, Japanese, Filipino) using chi-squared or t-tests, or Kruskal-Wallis test.

RESULTS: The study population included 69% whites, 6% Japanese, 6% Filipino, and 19% other races/ethnicity. Mean±SD age differed by race/ethnicity, with whites being the oldest at 53.5±13.6 years, followed by Japanese (51.6±16.5 years), and Filipinos (46.3±15.3 years; P<0.001 for between-group differences). Overall, 73.8% of patients were female, with no significant racial/ethnic differences. All patients either had an inpatient admission, an ED visit, or both. Approximately 75.5% of Filipinos had ≥1 inpatient admission versus 73.5% Japanese, and 48.9% whites (P<0.001 for between-group differences). MS was the primary diagnosis for inpatient admissions in 17.3% whites, 21.9% Japanese, and 32.0% Filipino patients, with no significant differences between groups. Across all groups, the next most common diagnoses were hearing loss and urinary tract infection. The most common primary diagnoses for ED visits across all groups were MS, headaches, and chest pain.

CONCLUSIONS: High rates of inpatient admissions and ED visits among MS patients in Hawaii suggest that case management, better education, and improved treatment regimens in an outpatient setting may yield efficient care delivery, decreased costs, and lower rates of hospital utilization in the Asian American population. Filipinos, in particular, were hospitalized at a younger age and more often than the Japanese and white groups.

STUDY SUPPORT: Sanofi