Insurance status, neighborhood income, and geographic location were associated with differences in 90-day readmission and hospital length of stay among people hospitalized with multiple sclerosis (MS), according to a nationwide retrospective cohort study presented at MSToronto2026.

Researchers analyzed 393,619 adult MS hospitalizations from the Nationwide Readmissions Database between 2016 and 2022. MS-specific readmission was defined as readmission within 90 days of discharge. Analyses accounted for age, sex, year, comorbidity burden, clinical severity, and mortality risk.

Key results included the following:

  • Overall, 15,006 hospitalizations (3.8%) were followed by an MS-specific readmission within 90 days.
  • Compared with privately insured patients, Medicare beneficiaries had 74% higher odds of readmission (OR, 1.74; 95% CI, 1.66-1.82), and Medicaid beneficiaries had 80% higher odds (OR, 1.80; 95% CI, 1.72-1.89).
  • Patients living in the lowest-income neighborhoods had higher odds of readmission than those in the highest-income quartile (OR, 1.36; 95% CI, 1.30-1.53).
  • Rural residents had lower observed odds of readmission than patients in large metropolitan areas (OR, 0.79; 95% CI, 0.76-0.83).
  • Mean hospital length of stay was 5.7 days. Medicaid coverage was associated with approximately 1.1 additional days and residence in the lowest-income quartile with approximately 0.4 additional days.

The authors noted that the lower observed readmission rates in rural populations occurred alongside shorter hospital stays and may reflect differences in health care access or delivery.

Source: Wong KH, Kitagawa R, Rose J, et al. Inequities in multiple sclerosis readmission: a nationwide study of social and structural determinants of healthcare utilization. Presented at: MS Toronto 2026; October 20-23, 2026; Toronto, ON, Canada.