Nationwide trends in medical expenditures among adults with epilepsy: 2003–2014

Alain Lekoubou, Kinfe G. Bishu, Bruce Ovbiagele

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective Healthcare expenditure among adults with epilepsy is high. There is a paucity of published data on trends in the nationwide economic impact of epilepsy. This study examines trends in healthcare expenditures and components in U.S. adults with epilepsy between 2003 and 2014. Methods We analyzed 12 years of data representing a weighted sample of 1,942,413 U.S. adults aged ≥ 18 years with epilepsy using Medical Expenditure Panel Survey Household Component (MEPS-HC), 2003–2014 data. We used a novel two-part model (adjusting for demographic, comorbidity, and time) to estimate the incremental healthcare expenditures by epilepsy status. Pre and post Affordable Care Act era costs were compared. Results Overall unadjusted annual mean medical expenditures for patients with epilepsy was $15,324. Individuals with epilepsy had nearly three times higher overall unadjusted mean expenditure than those without epilepsy ($15,324, 95%CI: 2778–17,871 vs. $5824, 95%CI: 5722–5926). The unadjusted annual mean medical expenditure decreased over time from $17,994 (95% CI $10,754–$25,234) in 2003/2006 to $13,848 (95% CI: $11,371–$16,324) in 2011/2014; a trend driven primarily by a decrease in inpatient expenditures from $5613 to $4113. Having a diagnosis of epilepsy increased health expenditure by $8598 which was 2.5 to 6 times greater than the equivalent incremental health expenditures for other selected comorbidities. Healthcare expenditure among adults with epilepsy was $4083 lower in the post- Affordable Care Act. Conclusion Over the last decade, individuals with epilepsy incurred significantly higher medical expenditures than those without epilepsy, but overall healthcare expenditure decreased over time due to a decrease in inpatient expenditures.

Original languageEnglish (US)
Pages (from-to)113-120
Number of pages8
JournalJournal of the neurological sciences
Volume384
DOIs
StatePublished - Jan 15 2018

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Health Expenditures
Epilepsy
Delivery of Health Care
Patient Protection and Affordable Care Act
Comorbidity
Inpatients
Economics
Demography

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

@article{15070e24376e477c991666366b86c210,
title = "Nationwide trends in medical expenditures among adults with epilepsy: 2003–2014",
abstract = "Objective Healthcare expenditure among adults with epilepsy is high. There is a paucity of published data on trends in the nationwide economic impact of epilepsy. This study examines trends in healthcare expenditures and components in U.S. adults with epilepsy between 2003 and 2014. Methods We analyzed 12 years of data representing a weighted sample of 1,942,413 U.S. adults aged ≥ 18 years with epilepsy using Medical Expenditure Panel Survey Household Component (MEPS-HC), 2003–2014 data. We used a novel two-part model (adjusting for demographic, comorbidity, and time) to estimate the incremental healthcare expenditures by epilepsy status. Pre and post Affordable Care Act era costs were compared. Results Overall unadjusted annual mean medical expenditures for patients with epilepsy was $15,324. Individuals with epilepsy had nearly three times higher overall unadjusted mean expenditure than those without epilepsy ($15,324, 95{\%}CI: 2778–17,871 vs. $5824, 95{\%}CI: 5722–5926). The unadjusted annual mean medical expenditure decreased over time from $17,994 (95{\%} CI $10,754–$25,234) in 2003/2006 to $13,848 (95{\%} CI: $11,371–$16,324) in 2011/2014; a trend driven primarily by a decrease in inpatient expenditures from $5613 to $4113. Having a diagnosis of epilepsy increased health expenditure by $8598 which was 2.5 to 6 times greater than the equivalent incremental health expenditures for other selected comorbidities. Healthcare expenditure among adults with epilepsy was $4083 lower in the post- Affordable Care Act. Conclusion Over the last decade, individuals with epilepsy incurred significantly higher medical expenditures than those without epilepsy, but overall healthcare expenditure decreased over time due to a decrease in inpatient expenditures.",
author = "Alain Lekoubou and Bishu, {Kinfe G.} and Bruce Ovbiagele",
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Nationwide trends in medical expenditures among adults with epilepsy : 2003–2014. / Lekoubou, Alain; Bishu, Kinfe G.; Ovbiagele, Bruce.

In: Journal of the neurological sciences, Vol. 384, 15.01.2018, p. 113-120.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nationwide trends in medical expenditures among adults with epilepsy

T2 - 2003–2014

AU - Lekoubou, Alain

AU - Bishu, Kinfe G.

AU - Ovbiagele, Bruce

PY - 2018/1/15

Y1 - 2018/1/15

N2 - Objective Healthcare expenditure among adults with epilepsy is high. There is a paucity of published data on trends in the nationwide economic impact of epilepsy. This study examines trends in healthcare expenditures and components in U.S. adults with epilepsy between 2003 and 2014. Methods We analyzed 12 years of data representing a weighted sample of 1,942,413 U.S. adults aged ≥ 18 years with epilepsy using Medical Expenditure Panel Survey Household Component (MEPS-HC), 2003–2014 data. We used a novel two-part model (adjusting for demographic, comorbidity, and time) to estimate the incremental healthcare expenditures by epilepsy status. Pre and post Affordable Care Act era costs were compared. Results Overall unadjusted annual mean medical expenditures for patients with epilepsy was $15,324. Individuals with epilepsy had nearly three times higher overall unadjusted mean expenditure than those without epilepsy ($15,324, 95%CI: 2778–17,871 vs. $5824, 95%CI: 5722–5926). The unadjusted annual mean medical expenditure decreased over time from $17,994 (95% CI $10,754–$25,234) in 2003/2006 to $13,848 (95% CI: $11,371–$16,324) in 2011/2014; a trend driven primarily by a decrease in inpatient expenditures from $5613 to $4113. Having a diagnosis of epilepsy increased health expenditure by $8598 which was 2.5 to 6 times greater than the equivalent incremental health expenditures for other selected comorbidities. Healthcare expenditure among adults with epilepsy was $4083 lower in the post- Affordable Care Act. Conclusion Over the last decade, individuals with epilepsy incurred significantly higher medical expenditures than those without epilepsy, but overall healthcare expenditure decreased over time due to a decrease in inpatient expenditures.

AB - Objective Healthcare expenditure among adults with epilepsy is high. There is a paucity of published data on trends in the nationwide economic impact of epilepsy. This study examines trends in healthcare expenditures and components in U.S. adults with epilepsy between 2003 and 2014. Methods We analyzed 12 years of data representing a weighted sample of 1,942,413 U.S. adults aged ≥ 18 years with epilepsy using Medical Expenditure Panel Survey Household Component (MEPS-HC), 2003–2014 data. We used a novel two-part model (adjusting for demographic, comorbidity, and time) to estimate the incremental healthcare expenditures by epilepsy status. Pre and post Affordable Care Act era costs were compared. Results Overall unadjusted annual mean medical expenditures for patients with epilepsy was $15,324. Individuals with epilepsy had nearly three times higher overall unadjusted mean expenditure than those without epilepsy ($15,324, 95%CI: 2778–17,871 vs. $5824, 95%CI: 5722–5926). The unadjusted annual mean medical expenditure decreased over time from $17,994 (95% CI $10,754–$25,234) in 2003/2006 to $13,848 (95% CI: $11,371–$16,324) in 2011/2014; a trend driven primarily by a decrease in inpatient expenditures from $5613 to $4113. Having a diagnosis of epilepsy increased health expenditure by $8598 which was 2.5 to 6 times greater than the equivalent incremental health expenditures for other selected comorbidities. Healthcare expenditure among adults with epilepsy was $4083 lower in the post- Affordable Care Act. Conclusion Over the last decade, individuals with epilepsy incurred significantly higher medical expenditures than those without epilepsy, but overall healthcare expenditure decreased over time due to a decrease in inpatient expenditures.

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