Healthcare Resource Utilization Among Persons with Epilepsy Treated by Different Healthcare Providers

Objective: To examine healthcare resource utilization and costs as a function of epilepsy provider type among persons with epilepsy (PWE) from the caregiver’s perspective. Methods: A cross-sectional survey of 500 caregivers of PWE, recruited through the Epilepsy Foundation and Light Speed research panels, was performed. The IRB-approved survey assessed patient and caregiver demographic characteristics, aspects of epilepsy provider management, epilepsy severity and treatment, resource utilization (past six months) and out-of-pocket costs (monthly) for epilepsy treatment. Epilepsy providers were stratified as a general practitioner/pediatrician/nurse practitioner (GP) or a neurologist/pediatric neurologist (Neuro). Differences in resource utilization and out-of-pocket costs were examined by cohort using a series of general linear regression models to control for caregiver/patient demographics and frequency of seizures. Results: Among the 500 caregivers, 79.4[percnt] (n=397) reported PWE were treated by a Neuro and 20.6[percnt] by a GP. PWE treated by a Neuro vs. a GP reported experiencing more seizures in the past month (median: 2.0 vs. 1.0, pu003c0.05) and were more likely to be treated with an antiepileptic medication (93.5[percnt] vs. 83.5[percnt], p=0.001). The number of seizures was correlated with the number of provider visits (r= 0.18, pu003c0.001). After adjustments, PWE treated by a Neuro vs. a GP reported fewer hospitalizations (0.43 vs. 0.80, p=0.04) and lower out-of-pocket costs due to hospitalizations ($8.93 vs. $374.02). No significant differences were found on the number of provider visits, out-of-pocket costs for antiepileptic medication or total out-of-pocket costs. Conclusions: According to caregivers, PWE who are treated primarily by a Neuro vs. a GP were more likely to receive antiepileptic medications and were less likely to have a hospitalization. This was true even though they had the same outpatient utilization and total out-of-pocket costs. These results will inform providers and payers on the benefit of receiving treatment for epilepsy through a specialist. Disclosure: Dr. Helmers has received research support from UCB Pharma. Dr. Gupta has received personal compensation for activities with Kantar Health as an employee. Dr. Gupta has received personal compensation for activities with Kantar Health as an employee.