title: [Healthcare management of an epilepsy clinic: factors involved in the demand for health care and clinical situation of patients].
abstract: BACKGROUND
  Epilepsy is a chronic illness that requires a long-term periodic follow-up of the patient and this means that as time goes by the number of patients attended increases, with the ensuing added cost for the healthcare system.
  
  
  OBJECTIVE
  To determine the factors involved in the time until an epileptic patient's next visit.
  
  
  METHODS
  Our sample consisted of a selection of patients who visited the epilepsy clinic at our hospital consecutively during one year. Their clinical situation and relationship with the medical advice they were given, together with the factors involved in the time elapsed until the next visit, were analysed by means of predictive econometric models.
  
  
  RESULTS
  There is a clear association between the patient's clinical situation and the modification of the treatment proposed by the neurologist in the previous visit. The factors involved in the time until the next visit were the frequency of seizures, adverse side effects from medicines -above all those that affect cognition- and the medical advice given to the patient. Polytherapy, psychoaffective disorders or the patient's social situation were not found to be significant.
  
  
  CONCLUSIONS
  Follow-up visits in a specific epilepsy clinic improves the patient's situation. This is the first analysis of the demand for healthcare in patients with epilepsy conducted by means of econometric methods and from a mixed physician-patient perspective. Since the factors that determine the time until the next visit can be modified, the number of visits per year could be reduced, thus improving patients' clinical situation. We suggest a greater amount of time should be spent per visit so as to be able to have a bearing on it and thereby cut costs in the long term.
authors: Servicio de Neurología, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Espana. guillerminagmartin@gmail.com
authors: Guillermina
authors: G
authors: García-Martín
authors: Guillermina
authors: G
authors: Martín-Reyes
authors: Marc Stefan
authors: MS
authors: Dawid-Milner
authors: M Isabel
authors: MI
authors: Chamorro-Muñoz
authors: Francisco
authors: F
authors: Pérez-Errazquin
authors: Manuel
authors: M
authors: Romero-Acebal
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001071:Appointments and Schedules; D015897:Comorbidity; D017046:Cost Savings; D019468:Disease Management; D004827:Epilepsy / Q000188:drug therapy / Q000191:economics; D005260:Female; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D017059:Models, Econometric; D009462:Neurology / Q000191:economics / Q000458:organization & administration*; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000458:organization & administration*; D016012:Poisson Distribution; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants