Health resource use in epilepsy: Significant disparities by age, gender, and aboriginal status.
OBJECTIVE
Epilepsy imposes a significant burden on society. The objective of this study was to estimate health resource utilization (HRU) over a 1-year period in epilepsy patients, using administrative databases.


METHODS
Three administrative databases (inpatient, emergency, and physician claims) were used to identify epilepsy cases. HRU variables included general physician (GP) and emergency (ER) visits, physician billings, hospitalizations, and length of stay (LOS). Logistic regression was used to determine the association between demographic variables and HRU variations.


RESULTS
Among the 1,431 patients with a mean age of 37.5 +/- 17.3 years, 56 (4%) were aboriginal. Ninety-six percent of patients saw a GP or a specialist (outpatient visit), 12% were hospitalized, and 8% visited the ER. Younger patients were more likely to see a neurologist (OR = 1.7, 95% CI 1.3-2.3), visit the ER (OR = 4.9, 95% CI 3.2-7.4), or be hospitalized (OR = 2.9, 95% CI 2.0-4.3). Females were less likely to see a GP but more likely to see a neurologist. Aboriginals were more likely than nonaboriginals to visit the ER (OR = 2.3, 95% CI 1.1-5.0) or be hospitalized (OR = 2.8, 95% CI 1.5-5.1) but less likely to see a neurologist (OR = 0.3, 95% CI 0.2-0.6). Welfare status and residence location (urban vs. rural) were not associated with HRU level.


CONCLUSIONS
We demonstrated the feasibility of using administrative databases to assess HRU in epilepsy. We also uncovered disparities in HRU by age, gender, and by aboriginal status, suggesting possible internal or external barriers to specialized care in some groups.
Jetté
Nathalie
N
Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. njette@ucalgary.ca
Quan
Hude
H
Faris
Peter
P
Dean
Stafford
S
Li
Bing
B
Fong
Andrew
A
Wiebe
Samuel
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D002170:Canada; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012737:Sex Factors