title: Improved health care resource utilization following video-EEG-confirmed diagnosis of nonepileptic psychogenic seizures.
abstract: The economic burden of epilepsy is well recognized. However, empirical investigation establishing costs associated with the diagnosis and treatment of non-epileptic psychogenic seizures (NEPS) is lacking. We studied 20 patients with video/EEG monitoring-confirmed NEPS to determine the effect of definitive diagnosis and treatment on medical costs and utilization. A medical resource utilization questionnaire and inpatient medical chart review were employed to calculate utilization information. Medication usage, outpatient visits, emergency room admissions, and diagnostic testing over a 6-month pre-diagnosis and a 6-month post-diagnosis period were compared. There was an 84% average reduction in total seizure-related medical charges in the 6 months following NEPS diagnosis. Average diagnostic testing charges declined 76%, average medication charges decreased 69%, outpatient clinic visits declined 80%, and emergency room visits reduced by 97%. A majority of patients obtaining a definitive inpatient video/EEG-seizure-monitoring-confirmed NEPS diagnosis experience substantial reductions in health care utilization and dollar costs.
authors.affiliation: Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, School of Medicine, 35294-0021, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Martin
authors.forename: F G
authors.initials: FG
authors.lastname: Gilliam
authors.forename: M
authors.initials: M
authors.lastname: Kilgore
authors.forename: E
authors.initials: E
authors.lastname: Faught
authors.forename: R
authors.initials: R
authors.lastname: Kuzniecky
mesh_terms: D000328:Adult; D000407:Alabama; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D003943:Diagnostic Techniques, Neurological / Q000191:economics; D004569:Electroencephalography / Q000191:economics; D004827:Epilepsy / Q000175:diagnosis; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000191:economics*; D012640:Seizures / Q000175:diagnosis* / Q000191:economics* / Q000523:psychology; D013001:Somatoform Disorders / Q000175:diagnosis*; D014600:Utilization Review / Q000706:statistics & numerical data; D014741:Video Recording / Q000191:economics