Trends in hospitalization and readmission for pediatric epilepsy and underutilization of epilepsy surgery in the United States.

Published on Aug 1, 2020in Seizure-european Journal of Epilepsy2.522
· DOI :10.1016/J.SEIZURE.2020.05.013
Yusuke Okubo12
Estimated H-index: 12
(UCLA: University of California, Los Angeles),
Aria Fallah20
Estimated H-index: 20
(UCLA: University of California, Los Angeles)
+ 2 AuthorsHiroki Nariai8
Estimated H-index: 8
(UCLA Medical Center)
Sources
Abstract
Abstract Background Previous studies have shown the healthcare utilization for medically refractory epilepsy and epilepsy surgery until 2012 with disparities according to race/ethnicity and socioeconomic status. To extend these data and add other utilization information, we retrospectively investigated the nationwide trends in hospitalization and readmission during 2010–2015. Method We extracted data on inpatients who were diagnosed with epilepsy and those who received epilepsy surgery using the national inpatient sample and nationwide readmission database during 2010–2015. We estimated healthcare utilization related to pediatric epilepsy, the number of epilepsy surgeries, hospitalization rates and 30-day readmission rates. Results 100,000–120,000 children were hospitalized due to epilepsy each year. Hospitalization rates and 30-day readmission rates were 214.6–262.3 per 1000 patient-years and 72.4–78.0 per 1000 discharges, respectively. 1400–2000 children with epilepsy received epilepsy surgery, but the proportions of medically refractory epilepsy were estimated as 0.8%–1.2%. Disparities in patients receiving epilepsy surgery by race/ethnicity were observed during 2010–2012, but they were not after 2013. Children with higher household income levels had consistently higher proportions of receiving epilepsy surgery than those with lower levels. The hospitalization costs for epilepsy surgery were constant at 55,780–0,813 after adjusting for healthcare cost inflation, whereas the cost for epilepsy were slightly elevated from 15,984 to 7,426. Conclusions We provide novel insights into the current healthcare utilization for epilepsy and epilepsy surgery. Although the disparity of epilepsy surgery seemed to be mitigated, the surgery in children with medically refractory epilepsy was still underutilized.
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The Patient Protection and Affordable Care Act is an American law passed in March of 2010. Its primary goal is to achieve universal health insurance coverage by facilitating cooperation among employers, citizens, and the government. Its other objectives are to make healthcare more affordable while simultaneously increasing healthcare quality and reducing unnecessary spending. To this end, the Act puts specific emphasis on primary and preventative care. The Act requires that all US citizens and l...
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BackgroundNeurosurgical treatment may improve seizures in children and adolescents with drug-resistant epilepsy, but additional data are needed from randomized trials. MethodsIn this single-center trial, we randomly assigned 116 patients who were 18 years of age or younger with drug-resistant epilepsy to undergo brain surgery appropriate to the underlying cause of epilepsy along with appropriate medical therapy (surgery group, 57 patients) or to receive medical therapy alone (medical-therapy gro...
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Epilepsy surgery is the standard of care for focal drug-resistant epilepsy, but it is underutilized. Knowledge gaps and attitudes toward epilepsy surgery are partly responsible, and a new study explores whether the health-care infrastructure in developed countries influences access to and utilization of epilepsy surgery.
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Introduction: Magnetoencephalography (MEG) is a noninvasive technique that is used for presurgical evaluation of children with drug-resistant epilepsy (DRE).Areas covered: The contributions of MEG for localizing the epileptogenic zone are discussed, in particular in extra-temporal lobe epilepsy and focal cortical dysplasia, which are common in children, as well as in difficult to localize epilepsy such as operculo-insular epilepsy. Further, the authors review current evidence on MEG for mapping ...
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