Relationship between office-based provider visits and emergency department encounters among publicly-insured adults with epilepsy

Alain Zingraff Lekoubou Looti, Kinfe G. Bishu, Bruce Ovbiagele

Research output: Contribution to journalArticle

Abstract

Introduction: The proportion of adults with epilepsy using the emergency department (ED) is high. Among this patient population, increased frequency of office-based provider visits may be associated with lesser frequency of ED encounters, and key patient features may be linked to more ED encounters. Methods: We analyzed the Medical Expenditure Panel Survey Household Component (MEPS-HC) dataset for years 2003–2014, which represents a weighted sample of 842,249 publicly-insured US adults aged ≥ 18 years. The Hurdle Poisson model that accommodates excess zeros was used to estimate the association between office-based and ED visits. Results: Annual mean ED and office-based visits for publicly-insured adults with epilepsy were 0.70 and 10.8 respectively. Probability of at least one ED visit was 0.4% higher for every unit of office-based visit. Individuals in the high income category were less likely to visit the ED at least once while women with epilepsy had a higher likelihood of visiting the ED at least once. Among those who visited the ED at least once, there was a 0.3% higher likelihood of visiting the ED for every unit of office-based visit. Among individuals who visited the ED at least once, being aged 45–64 years, residing in the West, and the year 2011/14 were associated with higher ED visits. Conclusion: In this representative sample of publicly-insured adults with epilepsy, higher frequency of office visits was not associated with lower ED utilization, which may be due to underlying greater disease severity or propensity for more treatment complications.

Original languageEnglish (US)
Pages (from-to)235-239
Number of pages5
JournalEpilepsy and Behavior
Volume80
DOIs
StatePublished - Mar 1 2018

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Hospital Emergency Service
Epilepsy
Office Visits
Health Expenditures

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

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title = "Relationship between office-based provider visits and emergency department encounters among publicly-insured adults with epilepsy",
abstract = "Introduction: The proportion of adults with epilepsy using the emergency department (ED) is high. Among this patient population, increased frequency of office-based provider visits may be associated with lesser frequency of ED encounters, and key patient features may be linked to more ED encounters. Methods: We analyzed the Medical Expenditure Panel Survey Household Component (MEPS-HC) dataset for years 2003–2014, which represents a weighted sample of 842,249 publicly-insured US adults aged ≥ 18 years. The Hurdle Poisson model that accommodates excess zeros was used to estimate the association between office-based and ED visits. Results: Annual mean ED and office-based visits for publicly-insured adults with epilepsy were 0.70 and 10.8 respectively. Probability of at least one ED visit was 0.4{\%} higher for every unit of office-based visit. Individuals in the high income category were less likely to visit the ED at least once while women with epilepsy had a higher likelihood of visiting the ED at least once. Among those who visited the ED at least once, there was a 0.3{\%} higher likelihood of visiting the ED for every unit of office-based visit. Among individuals who visited the ED at least once, being aged 45–64 years, residing in the West, and the year 2011/14 were associated with higher ED visits. Conclusion: In this representative sample of publicly-insured adults with epilepsy, higher frequency of office visits was not associated with lower ED utilization, which may be due to underlying greater disease severity or propensity for more treatment complications.",
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Relationship between office-based provider visits and emergency department encounters among publicly-insured adults with epilepsy. / Lekoubou Looti, Alain Zingraff; Bishu, Kinfe G.; Ovbiagele, Bruce.

In: Epilepsy and Behavior, Vol. 80, 01.03.2018, p. 235-239.

Research output: Contribution to journalArticle

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