Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
Department of Neurosurgery, David Geffen School of Medicine, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, USA.
Seizure. 2020 Aug;80:263-269. doi: 10.1016/j.seizure.2020.05.013. Epub 2020 May 17.
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.
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.
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-$60,813 after adjusting for healthcare cost inflation, whereas the cost for epilepsy were slightly elevated from $15,984 to $17,426.
We provide novel insights into the current healthcare utilization for epilepsy and epilepsy surgery. Although the disparity of epilepsy surgery seemed to be mitigated, surgery in children with medically refractory epilepsy was still underutilized.
之前的研究表明，到 2012 年，在医疗难治性癫痫和癫痫手术方面，根据种族/族裔和社会经济地位，医疗保健的利用率存在差异。为了扩展这些数据并添加其他利用信息，我们回顾性地调查了 2010-2015 年全国范围内的住院和再入院趋势。
我们使用国家住院样本和全国再入院数据库，提取了 2010-2015 年被诊断患有癫痫和接受癫痫手术的住院患者的数据。我们估计了与儿科癫痫相关的医疗保健利用率、癫痫手术数量、住院率和 30 天再入院率。
每年约有 10 万至 12 万名儿童因癫痫住院。住院率和 30 天再入院率分别为每 1000 名患者年 214.6-262.3 例和每 1000 次出院 72.4-78.0 例。约有 1400-2000 名癫痫儿童接受了癫痫手术，但据估计，药物难治性癫痫的比例为 0.8%-1.2%。2010-2012 年期间，种族/族裔接受癫痫手术的患者存在差异，但 2013 年以后这种差异并不存在。家庭收入水平较高的儿童接受癫痫手术的比例始终高于收入水平较低的儿童。调整医疗成本通胀后，癫痫手术的住院费用保持在 55780-60813 美元不变，而癫痫的费用从 15984 美元略微上升至 17426 美元。
我们提供了有关癫痫和癫痫手术当前医疗保健利用情况的新见解。尽管癫痫手术的差异似乎有所缓解，但药物难治性癫痫儿童的手术仍未得到充分利用。
