Payer costs of patients diagnosed with epilepsy

Robert I. Griffiths, Peggy N. Schrammel, George L. Morris, Stacey H. Wills, David M Labiner, Michael J. Strauss

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Purpose: To identify the annual cost to a third-party payer of inpatient and outpatient services and prescription drugs for patients diagnosed with epilepsy or convulsions. Methods: Retrospective study using administrative and claims data from a private insurer in the Northeast United States with >1.8 million covered lives. Health plan members were included if they had a claim for epilepsy or convulsions and a claim for an antiepileptic drug (AED) between January 1992 and December 1996. Annual costs and frequencies of all medical services, and of services related to epilepsy, were compared among five groups of patients defined by the most intensive procedure they received: invasive therapeutic procedure (group 1); invasive diagnostic procedure without an invasive therapeutic procedure (group 2); noninvasive diagnostic procedure without an invasive procedure (group 3); neurologist or neurosurgeon visit without an invasive procedure or noninvasive diagnostic procedure (group 4); or none of the preceding services (group 5). Results: In the cohort of 9,090 patients meeting the inclusion criteria, mean age was 38 years, 53% were female, 30% had malignant disease, and 25% had cardiac disease. The mean annual cost of all medical services was $9,617. Mean annual costs of all services were $43,333, $29,847, $11,300, $4,362, and $5,855, and annual costs of inpatient and outpatient encounters coded as epilepsy plus AEDs were $24,369, $10,330, $3,127, $1,079, and $1,086, in groups 1-5, respectively. Services used to stratify patients into the groups accounted for 37% of the total costs. Conclusions: The annual costs of medical services for patients with epilepsy are high and vary considerably because of treatment of epilepsy and management of comorbidities.

Original languageEnglish (US)
Pages (from-to)351-358
Number of pages8
JournalEpilepsia
Volume40
Issue number3
StatePublished - 1999

Fingerprint

Epilepsy
Costs and Cost Analysis
Inpatients
Seizures
Health Insurance Reimbursement
Insurance Carriers
Prescription Drugs
Ambulatory Care
Anticonvulsants
Comorbidity
Heart Diseases
Outpatients
Therapeutics
Retrospective Studies
Health

Keywords

  • Cost
  • Database
  • Economic
  • Epilepsy-related information
  • Health care utilization

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Griffiths, R. I., Schrammel, P. N., Morris, G. L., Wills, S. H., Labiner, D. M., & Strauss, M. J. (1999). Payer costs of patients diagnosed with epilepsy. Epilepsia, 40(3), 351-358.

Payer costs of patients diagnosed with epilepsy. / Griffiths, Robert I.; Schrammel, Peggy N.; Morris, George L.; Wills, Stacey H.; Labiner, David M; Strauss, Michael J.

In: Epilepsia, Vol. 40, No. 3, 1999, p. 351-358.

Research output: Contribution to journalArticle

Griffiths, RI, Schrammel, PN, Morris, GL, Wills, SH, Labiner, DM & Strauss, MJ 1999, 'Payer costs of patients diagnosed with epilepsy', Epilepsia, vol. 40, no. 3, pp. 351-358.
Griffiths RI, Schrammel PN, Morris GL, Wills SH, Labiner DM, Strauss MJ. Payer costs of patients diagnosed with epilepsy. Epilepsia. 1999;40(3):351-358.
Griffiths, Robert I. ; Schrammel, Peggy N. ; Morris, George L. ; Wills, Stacey H. ; Labiner, David M ; Strauss, Michael J. / Payer costs of patients diagnosed with epilepsy. In: Epilepsia. 1999 ; Vol. 40, No. 3. pp. 351-358.
@article{1df065cfd4ee44a5ae80c813d5dbd84a,
title = "Payer costs of patients diagnosed with epilepsy",
abstract = "Purpose: To identify the annual cost to a third-party payer of inpatient and outpatient services and prescription drugs for patients diagnosed with epilepsy or convulsions. Methods: Retrospective study using administrative and claims data from a private insurer in the Northeast United States with >1.8 million covered lives. Health plan members were included if they had a claim for epilepsy or convulsions and a claim for an antiepileptic drug (AED) between January 1992 and December 1996. Annual costs and frequencies of all medical services, and of services related to epilepsy, were compared among five groups of patients defined by the most intensive procedure they received: invasive therapeutic procedure (group 1); invasive diagnostic procedure without an invasive therapeutic procedure (group 2); noninvasive diagnostic procedure without an invasive procedure (group 3); neurologist or neurosurgeon visit without an invasive procedure or noninvasive diagnostic procedure (group 4); or none of the preceding services (group 5). Results: In the cohort of 9,090 patients meeting the inclusion criteria, mean age was 38 years, 53{\%} were female, 30{\%} had malignant disease, and 25{\%} had cardiac disease. The mean annual cost of all medical services was $9,617. Mean annual costs of all services were $43,333, $29,847, $11,300, $4,362, and $5,855, and annual costs of inpatient and outpatient encounters coded as epilepsy plus AEDs were $24,369, $10,330, $3,127, $1,079, and $1,086, in groups 1-5, respectively. Services used to stratify patients into the groups accounted for 37{\%} of the total costs. Conclusions: The annual costs of medical services for patients with epilepsy are high and vary considerably because of treatment of epilepsy and management of comorbidities.",
keywords = "Cost, Database, Economic, Epilepsy-related information, Health care utilization",
author = "Griffiths, {Robert I.} and Schrammel, {Peggy N.} and Morris, {George L.} and Wills, {Stacey H.} and Labiner, {David M} and Strauss, {Michael J.}",
year = "1999",
language = "English (US)",
volume = "40",
pages = "351--358",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Payer costs of patients diagnosed with epilepsy

AU - Griffiths, Robert I.

AU - Schrammel, Peggy N.

AU - Morris, George L.

AU - Wills, Stacey H.

AU - Labiner, David M

AU - Strauss, Michael J.

PY - 1999

Y1 - 1999

N2 - Purpose: To identify the annual cost to a third-party payer of inpatient and outpatient services and prescription drugs for patients diagnosed with epilepsy or convulsions. Methods: Retrospective study using administrative and claims data from a private insurer in the Northeast United States with >1.8 million covered lives. Health plan members were included if they had a claim for epilepsy or convulsions and a claim for an antiepileptic drug (AED) between January 1992 and December 1996. Annual costs and frequencies of all medical services, and of services related to epilepsy, were compared among five groups of patients defined by the most intensive procedure they received: invasive therapeutic procedure (group 1); invasive diagnostic procedure without an invasive therapeutic procedure (group 2); noninvasive diagnostic procedure without an invasive procedure (group 3); neurologist or neurosurgeon visit without an invasive procedure or noninvasive diagnostic procedure (group 4); or none of the preceding services (group 5). Results: In the cohort of 9,090 patients meeting the inclusion criteria, mean age was 38 years, 53% were female, 30% had malignant disease, and 25% had cardiac disease. The mean annual cost of all medical services was $9,617. Mean annual costs of all services were $43,333, $29,847, $11,300, $4,362, and $5,855, and annual costs of inpatient and outpatient encounters coded as epilepsy plus AEDs were $24,369, $10,330, $3,127, $1,079, and $1,086, in groups 1-5, respectively. Services used to stratify patients into the groups accounted for 37% of the total costs. Conclusions: The annual costs of medical services for patients with epilepsy are high and vary considerably because of treatment of epilepsy and management of comorbidities.

AB - Purpose: To identify the annual cost to a third-party payer of inpatient and outpatient services and prescription drugs for patients diagnosed with epilepsy or convulsions. Methods: Retrospective study using administrative and claims data from a private insurer in the Northeast United States with >1.8 million covered lives. Health plan members were included if they had a claim for epilepsy or convulsions and a claim for an antiepileptic drug (AED) between January 1992 and December 1996. Annual costs and frequencies of all medical services, and of services related to epilepsy, were compared among five groups of patients defined by the most intensive procedure they received: invasive therapeutic procedure (group 1); invasive diagnostic procedure without an invasive therapeutic procedure (group 2); noninvasive diagnostic procedure without an invasive procedure (group 3); neurologist or neurosurgeon visit without an invasive procedure or noninvasive diagnostic procedure (group 4); or none of the preceding services (group 5). Results: In the cohort of 9,090 patients meeting the inclusion criteria, mean age was 38 years, 53% were female, 30% had malignant disease, and 25% had cardiac disease. The mean annual cost of all medical services was $9,617. Mean annual costs of all services were $43,333, $29,847, $11,300, $4,362, and $5,855, and annual costs of inpatient and outpatient encounters coded as epilepsy plus AEDs were $24,369, $10,330, $3,127, $1,079, and $1,086, in groups 1-5, respectively. Services used to stratify patients into the groups accounted for 37% of the total costs. Conclusions: The annual costs of medical services for patients with epilepsy are high and vary considerably because of treatment of epilepsy and management of comorbidities.

KW - Cost

KW - Database

KW - Economic

KW - Epilepsy-related information

KW - Health care utilization

UR - http://www.scopus.com/inward/record.url?scp=0032964328&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032964328&partnerID=8YFLogxK

M3 - Article

C2 - 10080518

AN - SCOPUS:0032964328

VL - 40

SP - 351

EP - 358

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 3

ER -