کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6012604 1579858 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Healthcare utilization and costs in adults with stable and uncontrolled epilepsy
ترجمه فارسی عنوان
استفاده از خدمات بهداشتی و هزینه در بزرگسالان مبتلا به صرع پایدار و کنترل نشده
کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی علوم اعصاب رفتاری
چکیده انگلیسی


- We compared utilization and costs in patients with uncontrolled epilepsy to those with stable epilepsy.
- The study shows that morbidity and costs are higher in patients with uncontrolled epilepsy.
- Patients with uncontrolled epilepsy use more nonepilepsy-related healthcare services.
- Epilepsy-related costs account for < 50% of the overall healthcare costs.

Despite the availability of numerous antiepileptic drugs (AEDs), some epilepsies remain resistant to treatment. We compared utilization and costs in patients with uncontrolled epilepsy to those with stable epilepsy. Claims data (2007-2009) were used to identify adults with epilepsy requiring additional AED therapy (having uncontrolled epilepsy) and those not requiring additional AED therapy (having stable epilepsy). The date in 2008 on which an additional AED was started was the index date for patients with uncontrolled epilepsy, and a randomly selected date was used for patients with stable epilepsy, whose AED use was unchanged in the preceding year. In the postindex year, all pharmacy and medical claims were used to estimate overall utilization and costs; claims with epilepsy in any diagnosis field were used to estimate epilepsy-related outcomes. Outcomes were adjusted using multivariate analyses. We identified 1536 patients with uncontrolled epilepsy and 8571 patients with stable epilepsy (mean age: 42.8 years; female: 48%). Patients with uncontrolled epilepsy had higher comorbidity rates (p < .02). A greater proportion of patients with uncontrolled epilepsy had ≥ 1 hospitalization or emergency department visit (p < .001). Patients with uncontrolled epilepsy had a greater mean length of hospital stay and more physician office visits (p < .034). After adjustment, the odds of hospitalization (OR: 1.8, any diagnosis; 2.2, epilepsy-related) and emergency department visit (OR: 1.6, any diagnosis; 1.9, epilepsy-related) were greater for patients with uncontrolled epilepsy. Annual overall ($23,238 vs. $13,839) and epilepsy-related ($12,399 vs. $5511) costs were higher in patients with uncontrolled epilepsy and remained higher after adjustment (p < .001). Patients with uncontrolled epilepsy use more services and incur higher costs compared with those with stable epilepsy. Epilepsy-related costs accounted for < 50% of the total costs, suggesting that comorbid conditions and/or underidentification of utilization may substantially contribute to costs.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Epilepsy & Behavior - Volume 31, February 2014, Pages 356-362
نویسندگان
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