Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
Department of Medicine, Medical University of South Carolina, Charleston, SC, USA; Section of Health Systems Research and Policy, Medical University of South Carolina, Charleston, SC, USA.
J Neurol Sci. 2018 Jan 15;384:113-120. doi: 10.1016/j.jns.2017.11.025. Epub 2017 Nov 21.
Healthcare expenditure among adults with epilepsy is high. There is a paucity of published data on trends in the nationwide economic impact of epilepsy. This study examines trends in healthcare expenditures and components in U.S. adults with epilepsy between 2003 and 2014.
We analyzed 12years of data representing a weighted sample of 1,942,413U.S. adults aged ≥18years with epilepsy using Medical Expenditure Panel Survey Household Component (MEPS-HC), 2003-2014 data. We used a novel two-part model (adjusting for demographic, comorbidity, and time) to estimate the incremental healthcare expenditures by epilepsy status. Pre and post Affordable Care Act era costs were compared.
Overall unadjusted annual mean medical expenditures for patients with epilepsy was $15,324. Individuals with epilepsy had nearly three times higher overall unadjusted mean expenditure than those without epilepsy ($15,324, 95%CI: 2778-17,871 vs. $5824, 95%CI: 5722-5926). The unadjusted annual mean medical expenditure decreased over time from $17,994 (95% CI $10,754-$25,234) in 2003/2006 to $13,848 (95% CI: $11,371-$16,324) in 2011/2014; a trend driven primarily by a decrease in inpatient expenditures from $5613 to $4113. Having a diagnosis of epilepsy increased health expenditure by $8598 which was 2.5 to 6 times greater than the equivalent incremental health expenditures for other selected comorbidities. Healthcare expenditure among adults with epilepsy was $4083 lower in the post- Affordable Care Act.
Over the last decade, individuals with epilepsy incurred significantly higher medical expenditures than those without epilepsy, but overall healthcare expenditure decreased over time due to a decrease in inpatient expenditures.
成人癫痫患者的医疗支出很高。关于癫痫对全国经济影响的趋势，发表的数据很少。本研究调查了 2003 年至 2014 年美国癫痫患者医疗支出及组成部分的变化趋势。
我们使用医疗支出面板调查家庭组成部分（MEPS-HC）2003-2014 年的数据，分析了代表 1942413 名年龄≥18 岁的美国癫痫患者加权样本的 12 年数据。我们使用一种新的两部分模型（调整人口统计学、合并症和时间）来估计癫痫患者的增量医疗支出。比较了平价医疗法案前后的成本。
总体而言，癫痫患者未经调整的年平均医疗支出为 15324 美元。癫痫患者的总未经调整平均支出几乎是无癫痫患者的三倍（15324 美元，95%CI：2778-17871 美元与 5824 美元，95%CI：5722-5926 美元）。未经调整的年平均医疗支出随着时间的推移而下降，从 2003/2006 年的 17994 美元（95%CI：10754-25234 美元）降至 2011/2014 年的 13848 美元（95%CI：11371-16324 美元）；这一趋势主要是由于住院支出从 5613 美元降至 4113 美元。诊断为癫痫会增加 8598 美元的健康支出，比其他选定合并症的等效增量健康支出高 2.5 到 6 倍。平价医疗法案实施后，癫痫患者的医疗支出减少了 4083 美元。
在过去十年中，癫痫患者的医疗支出明显高于无癫痫患者，但由于住院支出的减少，总体医疗支出随着时间的推移而下降。
