College of Pharmacy, Al-Rashed University, Baghdad, Iraq.
Seizure. 2012 Dec;21(10):764-9. doi: 10.1016/j.seizure.2012.08.005. Epub 2012 Aug 29.
Aims of this study were to estimate the first-year medical care costs of newly diagnosed children with structural-metabolic epilepsy and to determine the cost-driving factors in the selected population.
This was a prevalence-based retrospective chart review that included patients who attended a pediatric neurology clinic in a tertiary referral center in Malaysia. The total first-year medical care costs were estimated from the provider (i.e., hospital) perspective, using a bottom-up, microcosting analysis. Medical chart/billing data (i.e., case reports) obtained from the hospital (i.e., provider) were collected to determine the resources used. Prices or cost data were standardized for the year 2010 (One Malaysian Ringgit MYR is equivalent to 0.26 Euro or 0.32 USD).
The most expensive item in the costs list was antiepileptic drugs, whereas ultrasound examination represented the cheapest item. Hospitalization and the use of non-antiepileptic drugs were the second and third most costly items, respectively. The cost of therapeutic drug monitoring comprised only a small proportion of the total annual expenditure. None of the demographic variables (i.e., gender, race, and age) significantly impacted the first-year medical care costs. Similarly, child development, seizure type, therapy type (i.e., polytherapy versus monotherapy), and therapeutic drug monitoring utilization were also not associated with the cost of management. The first-year medical care costs positively correlated with seizure frequency (r(s)=0.294, p=0.001). However, the only variable that significantly predict the first-year medical care costs was the type of antiepileptic drugs (R(2)=0.292, F=7.772, p<0.001).
This investigation was the first cost analysis study of epilepsy in Malaysia. The total first-year medical care costs for 120 patients with structural-metabolic epilepsy were MYR 202,816 (i.e., MYR 1690.13 per patient per year). The study findings highlight the importance of optimizing seizure control in reducing the cost of management.
本研究旨在估算新诊断结构性代谢性癫痫儿童的首年医疗费用，并确定所选人群的成本驱动因素。
这是一项基于患病率的回顾性图表审查，包括在马来西亚一家三级转诊中心的儿科神经病学诊所就诊的患者。从提供者（即医院）的角度使用自上而下的微观成本分析估算首年总医疗费用。从医院（即提供者）收集医疗图表/计费数据（即病例报告）以确定使用的资源。价格或成本数据已标准化为 2010 年（1 林吉特马来西亚令吉 MYR 相当于 0.26 欧元或 0.32 美元）。
成本清单中最昂贵的项目是抗癫痫药物，而超声检查则代表最便宜的项目。住院治疗和使用非抗癫痫药物分别是第二和第三昂贵的项目。治疗药物监测的费用仅占总年度支出的一小部分。在首年医疗费用方面，没有一个人口统计学变量（即性别、种族和年龄）具有显著影响。同样，儿童发育、癫痫发作类型、治疗类型（即多药治疗与单药治疗）以及治疗药物监测的使用与管理成本也没有关联。首年医疗费用与癫痫发作频率呈正相关（r(s)=0.294，p=0.001）。然而，唯一显著预测首年医疗费用的变量是抗癫痫药物的类型（R(2)=0.292，F=7.772，p<0.001）。
这是马来西亚癫痫首次成本分析研究。120 例结构性代谢性癫痫患者的首年总医疗费用为 202,816 令吉马来西亚（即每位患者每年 1690.13 令吉马来西亚）。研究结果强调了优化癫痫发作控制在降低管理成本方面的重要性。
