Examining health service utilization, hospital treatment cost, and mortality of individuals with epilepsy and status epilepticus in New South Wales, Australia 2012–2016

Rebecca J. Mitchell, Geoffrey Herkes, Armin Nikpour, Andrew Bleasel, Patti Shih, Sanjyot Vagholkar, Frances Rapport

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Abstract

This study examined the health service utilization and hospital treatment cost of individuals with epilepsy by age group, mortality within 30 days, and surgical outcomes for individuals with refractory epilepsy in New South Wales (NSW), Australia. A retrospective examination of linked hospitalization and mortality data for individuals hospitalized with a diagnosis of epilepsy during 2012–2016. Hospitalized incidence rates per 1000 population were calculated, and negative binomial regression was used to examine temporal trends. Mortality within 30 days of hospitalization was identified, along with cause of death. There were 44,722 hospitalizations during the five-year period, with a hospitalization rate of 85.6 per 1000 population (95% confidence interval (CI): 84.7–86.4). Total hospital treatment costs were AUD$402.9 million. Children aged ≤ 17 years accounted for 32.0% of hospitalizations. Just over half to two-thirds of hospitalizations for each age group were for a principal diagnosis of epilepsy, with 2976 hospitalizations of individuals for status epilepticus. The overall mean hospital length of stay (LOS) for epilepsy hospitalizations was 5.1 days (standard deviation (SD) = 9.0). Thirty-day mortality was highest for individuals aged ≥ 65 years (6.7%), and epilepsy was identified as the underlying cause of death for 18.2% of deaths. This research has provided insight into the healthcare utilization profiles of individuals with epilepsy at different ages. Epilepsy hospitalizations constitute a substantial cost to the healthcare system, and better overall management of seizures and comorbid conditions is likely to lead to a reduction in the need for hospitalization.

LanguageEnglish
Pages9-16
Number of pages8
JournalEpilepsy and Behavior
Volume79
DOIs
Publication statusPublished - 1 Feb 2018

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South Australia
New South Wales
Status Epilepticus
Hospital Costs
Hospital Mortality
Health Care Costs
Health Services
Epilepsy
Hospitalization
Mortality
Cause of Death
Length of Stay
Age Groups
Delivery of Health Care
Population
Seizures
Confidence Intervals
Costs and Cost Analysis

Keywords

  • Comorbidities
  • Cost
  • Epilepsy
  • Healthcare utilization
  • Mortality
  • Population-based

Cite this

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title = "Examining health service utilization, hospital treatment cost, and mortality of individuals with epilepsy and status epilepticus in New South Wales, Australia 2012–2016",
abstract = "This study examined the health service utilization and hospital treatment cost of individuals with epilepsy by age group, mortality within 30 days, and surgical outcomes for individuals with refractory epilepsy in New South Wales (NSW), Australia. A retrospective examination of linked hospitalization and mortality data for individuals hospitalized with a diagnosis of epilepsy during 2012–2016. Hospitalized incidence rates per 1000 population were calculated, and negative binomial regression was used to examine temporal trends. Mortality within 30 days of hospitalization was identified, along with cause of death. There were 44,722 hospitalizations during the five-year period, with a hospitalization rate of 85.6 per 1000 population (95{\%} confidence interval (CI): 84.7–86.4). Total hospital treatment costs were AUD$402.9 million. Children aged ≤ 17 years accounted for 32.0{\%} of hospitalizations. Just over half to two-thirds of hospitalizations for each age group were for a principal diagnosis of epilepsy, with 2976 hospitalizations of individuals for status epilepticus. The overall mean hospital length of stay (LOS) for epilepsy hospitalizations was 5.1 days (standard deviation (SD) = 9.0). Thirty-day mortality was highest for individuals aged ≥ 65 years (6.7{\%}), and epilepsy was identified as the underlying cause of death for 18.2{\%} of deaths. This research has provided insight into the healthcare utilization profiles of individuals with epilepsy at different ages. Epilepsy hospitalizations constitute a substantial cost to the healthcare system, and better overall management of seizures and comorbid conditions is likely to lead to a reduction in the need for hospitalization.",
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