Diagnoses, procedures, drug utilization, comorbidities, and cost of health care for people with epilepsy in 2012

Andrew Wilner, B. K. Sharma, A. Thompson, A. Soucy, A. Krueger

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Our objective was to identify the top MD-office, inpatient and outpatient diagnoses, procedures, drug classes, comorbidities, and cost of health care for people with epilepsy. We examined health insurance claims for 8388 persons with epilepsy (females. =. 52%, males. =. 48%; average age. =. 35. years; privately insured. =. 78%, and Medicaid-insured. =. 22%) from eight health insurance plans for the year 2012. All of the top three diagnoses for MD-office place of service were either for other convulsions (780.39) or for epilepsy (345.90 and 345.40). Two of the top three primary diagnosis codes from the inpatient hospital and emergency department places of service were 780.39 and 345.90 for convulsions and epilepsy, respectively, while the third code was 786.50 for chest pain. The top three procedures from the MD-office setting were for immunizations (90471 and 90658) and blood counts (85025). The top three procedure codes from the outpatient hospital setting were 85025 for complete blood count, 80053 for comprehensive metabolic panel, and 80048 for basic metabolic panel. In the emergency department, the top three procedures were electrocardiogram (93010), computed tomography (70450), and chest X-ray (71020). The top five drug classes among prescription drugs billed using an NDC code were (1) anticonvulsants, (2) analgesic-opioids, (3) antidepressants, (4) penicillins, and (5) dermatologicals. The mean monthly health plan paid cost for each patient with epilepsy in 2012 was $1028 (SD. =. $3181). Of this total, $761 (SD. =. $2988; 74%) was for medical, and $267 (SD. =. $760; 26%) was for prescription pharmacy claims. Fifty-eight percent (58%) of the patients had one or more of 29 prespecified comorbidities, while 42% had none. Monthly health-care costs increased markedly as the number of comorbidities increased. This information should help guide cost estimates and resource allocation in order to optimally care for people with epilepsy.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalEpilepsy and Behavior
Volume41
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

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Drug Utilization
Drug Costs
Comorbidity
Epilepsy
Delivery of Health Care
Health Insurance
Health Care Costs
Hospital Emergency Service
Inpatients
Seizures
Outpatients
Cost Allocation
Prescription Drugs
Blood Cell Count
Resource Allocation
Hospital Departments
Medicaid
Chest Pain
Penicillins
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Diagnoses, procedures, drug utilization, comorbidities, and cost of health care for people with epilepsy in 2012. / Wilner, Andrew; Sharma, B. K.; Thompson, A.; Soucy, A.; Krueger, A.

In: Epilepsy and Behavior, Vol. 41, 01.12.2014, p. 83-90.

Research output: Contribution to journalArticle

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