Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, United Kingdom; Faculty of Pharmacy, Assiut University, Assiut, Egypt.
Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, United Kingdom.
Epilepsy Res. 2014 Mar;108(3):576-86. doi: 10.1016/j.eplepsyres.2013.12.014. Epub 2014 Jan 7.
We described the health resource utilisation (HRU) and associated direct medical costs of managing epilepsy in children and young people (CYP) using population-level data from the United Kingdom. The study cohort were CYP born between 1988 and 2004 who were newly diagnosed with epilepsy and identified using a nationally representative primary care database from the United Kingdom. Reference unit costs were applied to each element of HRU to calculate annual direct medical costs per child. We assessed whether HRU and costs differed by time from diagnosis, age, sex and socioeconomic deprivation. Of 798 CYP newly diagnosed with epilepsy, 56% were male and the mean age at diagnosis was 5.6 years. The highest burden of HRU was in the first year following diagnosis with a mean annual cost of £930 (95% confidence interval (CI) £839-1022) per child in this first year. This decreased to £461 (95%CI 368-551) in the second year which remained fairly constant each subsequent year (£413 (95% CI 282-540) in the 8th year). The highest contribution to the annual medical costs was from inpatient hospital admissions followed by the costs of AEDs. Mean annual medical costs were significantly higher in children under 6 years of age compared with older children (p<0.01), but were similar across socioeconomic groups (p=0.62). The direct medical costs of HRU in CYP with epilepsy are higher in the first year after diagnosis compared to subsequent years, reflecting HRU related to the diagnostic process in the first year. Medical costs did not vary substantially by sex or socioeconomic deprivation indicating a similar level of consultation and care across these groups.
我们使用来自英国的人群水平数据描述了儿童和青少年（CYP）癫痫管理的卫生资源利用（HRU）和相关直接医疗费用。研究队列是在 1988 年至 2004 年间出生的 CYP，他们被新诊断患有癫痫，并通过英国具有代表性的初级保健数据库识别出来。参考单位成本被应用于 HRU 的每个元素，以计算每个儿童的年度直接医疗费用。我们评估了 HRU 和成本是否因诊断后时间、年龄、性别和社会经济贫困程度而有所不同。在新诊断患有癫痫的 798 名 CYP 中，有 56%为男性，诊断时的平均年龄为 5.6 岁。诊断后第一年的 HRU 负担最重，每个孩子的年平均费用为 930 英镑（95%置信区间（CI）839-1022）。第二年降至 461 英镑（95%CI 368-551），随后每年基本保持不变（第 8 年为 413 英镑（95%CI 282-540））。对年度医疗费用贡献最大的是住院治疗，其次是抗癫痫药物的费用。与年龄较大的儿童相比，6 岁以下儿童的年平均医疗费用显著较高（p<0.01），但在社会经济群体中相似（p=0.62）。与诊断相关的 HRU 第一年诊断后 CYP 癫痫患者的 HRU 直接医疗费用高于随后几年，反映了与诊断过程相关的 HRU。医疗费用在性别或社会经济贫困程度方面没有显著差异，表明这些群体的咨询和护理水平相似。
