Abstracts

Rationale: Epilepsy continues to be a major source of morbidity and mortality in the United States. The objective of this study was to analyze socioeconomic trends of epilepsy management in the US using a national healthcare database. Methods: The nationwide inpatient sample (NIS) database was queried for admissions with the principal diagnosis of epilepsy between 1993-2008. The NIS is maintained by the Agency for Healthcare Research and Quality (AHQR), and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Metrics analyzed included number of admissions, length of stay, and hospital and total national charges.Results: Approximately 1,100,000 records during this 15 year-period were abstracted. There has been a 148% increase in number hospitalizations for epilepsy during this time period (68,676 in 1993 to 170,484 in 2008). The average hospital charge per admission for epileptic patients has increased significantly (p<0.001) from $10,500 to $23,909 (+137.9%). Length of stay decreased from 5.9 to 3.9 days (-33%, p<0.001). There has been a decrease in the percentage of in-hospital deaths by 57.9% (p<0.001). Total national charges associated with in-patient treatment of epilepsy in 2008 were in excess of 4 billion USD. Conclusions: Between 1993 and 2008, there has been a significant increase in the number of hospitalizations for the treatment of epilepsy in the US, with a concomitant increase in hospital and overall national charges. These findings suggest the need to critically analyze clinical and outcomes studies to ensure the efficacy and cost-effectiveness of the current treatment modalities for epilepsy in the US.