Impact of the COVID-19 Epidemic on Epilepsy Center Practice in the United States
Abstract number :
1.427
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2021
Submission ID :
1886469
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:56 AM
Authors :
Stephanie Ahrens, DO - Nationwide Children's Hospital/The Ohio State University; Adam Ostendorf, MD - Nationwide Children's Hospital/The Ohio State University; Fred Lado, MD, PhD - Hofstra Northwell Comprehensive Epilepsy Center; Susan Arnold, MD - UT Southwestern Children’s Medical Center Dallas; Shasha Bai, PhD - Pediatric Biostatistics Core at Emory University; Kevin Chapman, MD - Barrow Neurological Institute at Phoenix Children’s Hospital; Dave Clarke, MD - UT Health Austin Dell Children's Hospital; Mariah Eisner, MS - is Biostatistics Resource at Nationwide Children’s Hospital; Nathan Fountain, MD - University of Virginia; Johanna Gray, MPA - National Association of Epilepsy Centers; Muhammed Talha Gunduz, MN - Nationwide Children's Hospital/The Ohio State University; Jennifer Hopp, MD - University of Maryland; Ellen Riker, MHA - National Association of Epilepsy Centers; Stephan Schuele, MD, MPH - Northwestern University; Barbara Small, BA - National Association of Epilepsy Centers; Susan Herman, MD - Barrow Neurological Institute
Rationale: Persons with epilepsy, especially those with drug resistant epilepsy (DRE), may benefit from inpatient services such as admission to the epilepsy monitoring unit (EMU) and epilepsy surgery. The COVID-19 pandemic caused reductions in these services within the U.S. during 2020. This article highlights changes in resources, admissions and procedures among epilepsy centers accredited by the National Association of Epilepsy Centers (NAEC).
Methods: We compared data reported in 2019, prior to the COVID-19 pandemic and 2020 from all 260 level 3 and level 4 NAEC accredited epilepsy centers. Data were described using frequency for categorical variables and median for continuous variables and were analyzed by center level, center population category and geographical location. Qualitative responses from center directors to questions regarding the impact from COVID-19 were summarized utilizing thematic analysis. Responses from the NAEC center annual reports as well as a supplemental COVID-19 survey were included.
Results: EMU admissions declined 23% in 2020, with largest median reductions in level 3 centers (-44%) and adult centers (-39%). The drop in admissions was more substantial in the East North Central, East South Central, Mid Atlantic, and New England U.S. Census divisions. Survey respondents attributed reduced admissions to re-assigning EMU beds, restrictions on elective admissions, reduced staffing and patient reluctance for elective admission. Treatment surgeries declined 5.7%, with the largest reduction occurring in VNS implantations (-19%) and temporal lobectomies (-16%). All other procedure volumes increased, including a 35% increase in corpus callosotomies.
Conclusions: In the U.S., access to care for persons with epilepsy declined during the COVID-19 pandemic in 2020. Adult patients, those relying on level 3 centers for care and many persons in the eastern half of the US were most affected.
Funding: Please list any funding that was received in support of this abstract.: Award number 45141-0001-0321 from Nationwide Children's Hospital and Award Number 810712-1221-00 from the National Association of Epilepsy Centers.
Health Services (Delivery of Care, Access to Care, Health Care Models)