Solvent abuse.

Abstract

OBJECTIVE:To identify health insurance disparities in the population undergoing continuous EEG monitoring for epilepsy. DESIGN/METHODS:We reviewed the healthcare Cost and Utilization Project9s Nationwide Inpatient Sample (NIS) database from 2000 to 2011 for hospitalizations encoding epilepsy or convulsions as a primary diagnosis (ICD 9-CM codes 345.xx or 780.39).Continuous EEG (cEEG) monitoring was identified by procedure code 89.19. Multivariate regression model were generated after adjusting with confounders to evaluate association between payment type and cEEG utilization. RESULTS:Out of 2795525 hospitalizations for epilepsy or convulsions, 275814 (8.8[percnt]) had continuous EEG monitoring coded. In multivariate analysis, the odds of utilizing cEEG monitoring were lower in Medicare/Medicaid (Adjusted Odds Ratio [OR] 0.65; 95[percnt] Confidence Interval [CI] 0.60-0.71; Beta value [b]: -0.4293; p&lt;0.001) and self/no/other (OR 0.49; 95[percnt] CI 0.42-0.58; b: -0.6508; p&lt;0.001) as compared to private insurance. This effect does not vary over the year (p: 0.10 and P: 0.92 respectively for Medicare/Medicaid and self/no/other), between teaching or non teaching hospitals (p: 0.16 and P: 0.07) and between urban or rural hospitals (p: 0.99 and P: 0.97). Additionally, male gender, black and Hispanic ethnicity as compare to white and lowest quartile of median household income as compare to highest were each independently associated with lower utilization. CONCLUSION: In patients who were admitted with primary diagnosis of epilepsy or convulsions, rates of cEEG monitoring is associated with payment disparity. Further studies are needed to identify the factors leading to these disparities. <b>Disclosure:</b> Dr. dave has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Savani has nothing to disclose. Dr. Bhatia has nothing to disclose. Dr. Eccher has nothing to disclose.