Abstracts

Rationale: Hospitalizations and antiepileptic medications are the two most important driving forces that determine health care costs for people with epilepsy. We wanted to determine whether recent changes in epilepsy care, such as increased use of the vagus nerve stimulator, epilepsy surgery, and new antiepileptic drugs, have affected the rate of hospitalization. Methods: Data was obtained from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 2000 to 2006. ICD-9-CM codes defining epilepsy include diagnosis codes 345.00-345.91. Data from community and academic hospitals were included, but not federal or long term care, rehabilitation, psychiatric, alcoholism or chemical dependency hospitals. Results: Hospital stays associated with a principal diagnosis of epilepsy increased by 26,000 (55%) from 47,000 in the year 2000 to 73,000 in 2006. During this time, there was an overall increase in hospitalization rate in the US of only 8%. Hospitalizations increased most notably in the youngest age group (<18), and the middle-age group (45-64). Among children and adolescents, epilepsy hospitalizations increased by 8,900 (66%) from 13,500 in 2000 to 22,400 in 2006. Among 45-64 year olds, hospitalizations increased by 7,900 (83%) from 9,500 in 2000 to 17,400 in 2006. Conversely, there was a smaller increase in the hospital stays for the elderly (>65) of 2,500 (36%) from 6,900 in 2000 to 9,400 in 2006. Hospitalizations in the age group 18-44 increased by 7,000 (42%) from 16,600 in 2000 to 23,600 in 2006. Hospitalizations for grand mal status epilepticus increased by 4,000 from 13,000 hospital stays in the year 2000 to 17,000 in 2006, accounting for 15% (4,000/26,000) of the overall increase in hospitalizations. Length of stay for epilepsy hospitalizations decreased slightly from 4.8 days in 2000 to 4.3 days in 2006. Men and women accounted for about 50% each of hospitalizations in 2000 and 2006. Conclusions: Hospital stays associated with a principal diagnosis of epilepsy increased 55% between 2000 and 2006. The largest increases were seen for those younger than 18 years old (66%) and for 45-64 (83%) year olds. Status epilepticus accounted for 15% of the overall increase in hospitalizations. The reasons for these increases in hospitalizations require further investigation.