Non-elective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: a population-based study
Abstract number :
610
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2020
Submission ID :
2422951
Source :
www.aesnet.org
Presentation date :
12/6/2020 5:16:48 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Churl-Su Kwon, Icahn School of Medicine and Mount Sinai; Parul Agarwal -Icahn School of Medicine at Mount Sinai; Jung-yi Lin - Icahn School of Medicine at Mount Sinai; Madhu Mazumdar - Icahn School of Medicine at Mount Sinai; Mandip Dhamoon - Icahn School
Rationale:
Identifying adverse outcomes and examining trends and causes of non-elective admissions among those with epilepsy would be beneficial to optimize patient care and reduce health services utilization. We examined the association of epilepsy with discharge status, in-hospital mortality, length-of-stay, and charges. We also examined 10-year trends and causes of hospital admissions among those with and without epilepsy.
Method:
Non-elective hospital admission in persons with epilepsy were identified in the 2005-2014 National Inpatient Sample (NIS) using a validated ICD-9-CM case definition. The NIS is the largest US all-payer database including patient and hospital level variables, and represents hospitalizations in the general population. Descriptive statistics on trends and causes of admissions and multivariable regression analysis summarizing the association of epilepsy with the outcomes of interest are presented.
Results:
Out of 4,718,178 non-elective admissions in 2014, 3.80% (n=179,461) were in persons with epilepsy. Admissions in persons with epilepsy increased from 14,636 to 179,461 (p< 0.0001) between 2005 and 2014. As compared to those without epilepsy, hospital admissions in persons with epilepsy had higher odds of transfer to other facilities (OR=1.77, 95%CI:1.72-1.81, p< 0.0001), being discharged against medical advice (OR=1.48, 95%CI:1.38-1.59, p< 0.0001), incurred 4% greater total charges (p< 0.0001). Epilepsy, convulsions, pneumonia, mood disorders, cerebrovascular disease and septicaemia were the top causes for admissions in those with epilepsy.
Conclusion:
Future research should focus on designing targeted health care interventions that decrease the number of hospital admissions, reduce health services utilization and increase the odds of discharge home in people with epilepsy.
Funding:
:None
Health Services