在美国医疗保健环境中，心因性非癫痫性发作的诊断、费用和利用情况。
Diagnosis, costs, and utilization for psychogenic non-epileptic seizures in a US health care setting.
机构信息
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA.
出版信息
Psychosomatics. 2013 Jan-Feb;54(1):28-34. doi: 10.1016/j.psym.2012.08.005. Epub 2012 Nov 27.
BACKGROUND
Psychogenic non-epileptic seizures (PNES) pose a substantial burden to patients and the health care system, due to long diagnostic and treatment delays.
METHODS
This study used medical chart notes from 103 patients to shed light on the diagnostic process. Electronic medical records and cost data from a US health system were also used to investigate costs and utilization for the 12-months before and after PNES diagnosis.
RESULTS
The results show that accurate diagnosis was typically achieved via the use of multiple medical tests, including vEEG, magnetic resonance imaging (MRI), and computed tomography (CT) scans, as well as historical diagnostic and clinical information. In the year following PNES diagnosis, a decline in average visits (-1.45) and costs (-$1784) were observed. The largest cost savings were seen in neurology care and inpatient stays.
CONCLUSIONS
This study has implications for timely and accurate diagnosis of PNES, which may decrease the overall health care burden for individuals and the health care system.
背景
由于诊断和治疗的延迟，心因性非癫痫性发作（PNES）给患者和医疗保健系统带来了巨大的负担。
方法
本研究使用了 103 名患者的病历记录，以阐明诊断过程。还使用了来自美国医疗体系的电子病历和成本数据，以调查 PNES 诊断前后 12 个月的成本和利用率。
结果
研究结果表明，通过使用多种医疗测试，包括视频脑电图（vEEG）、磁共振成像（MRI）和计算机断层扫描（CT），以及历史诊断和临床信息，通常可以做出准确的诊断。在 PNES 诊断后的一年中，就诊次数（-1.45）和费用（-$1784）均有所下降。神经内科护理和住院费用的节省最大。
结论
本研究对 PNES 的及时准确诊断具有重要意义，这可能会降低个人和医疗保健系统的整体医疗负担。
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