Nationwide Patterns of Healthcare Utilization and Health related Quality of Life among US Adults with Epilepsy (P6-1.002)

Abstract

<h3>Objective:</h3> To analyze nationwide patterns of healthcare utilization and health related quality of life (HRQoL) among adults with epilepsy. <h3>Background:</h3> Epilepsy is one of the most disabling yet common neurological conditions. Contemporary information on patterns of nationwide healthcare utilization and health related quality of life are scanty in the United States. <h3>Design/Methods:</h3> We analyzed the Medical Expenditure Panel Survey Household Components (MEPS-HC) dataset covering the period of 2003 – 2014. Adults (aged ≥18 years) with and without epilepsy formed our study population, identified using the clinical classification code 83. Unadjusted Healthcare utilization (Inpatient admission, outpatient visits, prescription medication including refill, emergency room visits, and home health provider visits) and health related quality of life (Mental Health score [MCS-12] and Physical Health score [PCS-12]) were compared between adults with epilepsy vs. those without epilepsy. Multiple logistic regression and generalized linear models were used to analyze the independent associations of healthcare utilization and HRQoL with epilepsy. <h3>Results:</h3> Among 192,437,980 (weighted) individuals, 1,942,413 had epilepsy (1%). In the unadjusted model, adults with epilepsy had a higher rate of healthcare utilization and lower health-related quality of life. In the adjusted model, adults with epilepsy were more likely to utilize healthcare: inpatient admissions (Odds ratio, OR = 2.17, 95% confidence interval, CI = 1.89–2.49), outpatient visits (OR = 2.63, 95% CI = 2.13–3.25), medications (OR = 10.86, 95%CI = 7.13–16.5), emergency department visit (OR=2.16; 95% CI 1.922–2.444) and home health (OR=3.51; 95% CI 2.853–4.321). Epilepsy patients also had 6.9% lower MCS and 11.2% lower PCS than those with epilepsy. <h3>Conclusions:</h3> In this nationally representative analysis, compared to those without epilepsy, those with epilepsy have lower health-related quality of life and higher healthcare utilization, the latter showing significant heterogeneity across services. Future studies should identify the specific modifiable factors contributing these findings. <b>Disclosure:</b> Miss Yu has nothing to disclose. Dr. Lekoubou Looti has nothing to disclose. Kinfe Bishu has nothing to disclose. Dr. Ovbiagele has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Ovbiagele has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health.