- First year treatment costs were found to be substantial.
- Average cost of $20k per child with epilepsy in first year after diagnoses.
- Improving seizure control could reduce costs dramatically.
- Targeting and Improving quality of life issues could also reduce cost.
Improving seizure control and targeting health-related quality of life could reduce the substantial costs associated with pediatric epilepsy in the year after diagnosis, according to a new study published in the July 10 online edition of Neurology.
The study, which examined health care charges for children with epilepsy at Cincinnati Children’s Hospital Medical Center, found that the average charges were $20,084 per child in the first year. Costs were higher for children who had had seizure activity since diagnosis or experienced medication side effects. Charges were also higher for children who had poorer health-related quality of life at the time of diagnosis.
“The economic impact of pediatric epilepsy in the year following diagnosis is substantial,” wrote the researchers in the July 10 online edition of Neurology.
The Cincinnati Children’s Hospital’s epilepsy program is unusual because it automatically incorporates two behavioral health visits with a pediatric psychologist into the schedule of medical appointments in the first year. More typically, pediatric epilepsy centers refer for further evaluation only those children they think are showing signs of psychosocial problems, including learning difficulties, attention issues, behavioral problems, and depression.
“The goal is to target quality of life issues in addition to seizure control,” Jamie Ryan, PhD, a post-doctoral fellow at the hospital who led the study, told Neurology Today.
Patients at the Cincinnati center are scheduled for a 30 to 45-minute consultation with a pediatric psychologist specializing in epilepsy one month after their diagnosis, with a second visit at around six months. Caregivers are asked to complete the Pediatric Quality of Life Inventory (http://pedsql.org) at each neurology clinic visit. Dr. Ryan said that if those evaluations indicate a need for other services for patients and their families, appropriate follow-up or care, testing, or referrals are provided. The epilepsy center has three psychologists on staff.
“The initial visit with the psychologist provides an opportunity to see how patients are adjusting to the diagnosis and medication, learn about the family, and assess whether the child is experiencing any difficulties in daily life, such as school or managing emotions,” Dr. Ryan said. The hope is to get interventions in place early, before problems snowball, she added. The average total charge per patient for the behavioral health sessions in the epilepsy clinic was $333.
Dr. Ryan said she and her colleagues are now planning to analyze the cost-effectiveness of providing routine behavioral medicine services to patients.