Healthcare resource burden of newly diagnosed epilepsy in the US low-income elderly population

Abstract

ObjectiveTo assess the incremental and relative healthcare resource burden of new-onset epilepsy among the concurrently old and medically indigent. DesignA retrospective cohort study employing Arizona Medicaid claims data years from 2008 through 2010. SettingThe elderly poor; dually eligible beneficiaries. SubjectsTo qualify as a patient with newly diagnosed epilepsy, patients were required to (1) be at least 65 years of age; (2) be continuously enrolled in Arizona Medicaid for at least 12 months; (3) have seizure-related healthcare claims; (4) no claims with a diagnosis code of 345.x1; and (5) have a one-year clean period without evidence of epilepsy or seizure disorder. MeasurementsThe outcome variables assessed included total monthly healthcare, inpatient, outpatient, and prescription costs to Arizona Medicaid, incidence rate of inpatient stay, and incidence rate of physician visits. ResultsA total of 472 newly diagnosed patients (15% age≥85, 64% female) and 60,256 controls (22% age≥85, 65% female) were identified for this analysis. Matched cases had 2.78, 3.82, 2.70, 1.55, 2.72, and 1.28 times greater monthly total healthcare costs (P<0.001), inpatient costs (P<0.001), outpatient costs (P<0.001), prescription drug costs (P=0.149), inpatient visits (P<0.001), and physician visits (P=0.377) compared with their counterpart. Incremental monthly total healthcare costs in patients with newly diagnosed epilepsy were on average 2066 (SE=432) US dollars. ConclusionsThe elderly poor with newly diagnosed epilepsy in the US had significantly greater healthcare resource use compared with those without epilepsy.