title: Regional variation in prevalence and healthcare utilization due to epilepsy in Sweden.
abstract: OBJECTIVE
  To estimate the regional differences in the prevalence of epilepsy and the associated costs due to inpatient and outpatient care and anti-epileptic drug (AED) utilization for the years 2005 and 2011 in Sweden.
  
  
  METHODS
  Region-specific estimates of the prevalence of epilepsy were obtained using a method based on a linkage of the healthcare and pharmaceutical registries and the cause of death registry. Regional cost components were estimated using registry data by region on inpatient and outpatient care utilization, AED sales, and mortality. Per-patient utilization and monetary costs were calculated.
  
  
  RESULTS
  Estimated prevalence of epilepsy varied substantially across the regions in 2011, from 0.76% in Jämtland to 1.08% in Gotland. The national prevalence was 0.88%. The average number of hospitalizations per patient and year decreased at the national level between 2005 and 2011. At the national level, the per-patient specialized care (outpatient) utilization also decreased between 2005 and 2011. However, at the regional level, the decrease was not uniform, and in some counties, the per-patient utilization increased during the period studied. The per-patient utilization of AEDs increased in all counties, except Kronoberg, between 2005 and 2011. Moreover, between-region differences in healthcare and AED utilization, and significant differences between regions and national averages were revealed. Similarly, regional per-patient costs were shown to deviate from the national average in 13 of 21 regions.
  
  
  CONCLUSIONS
  There is significant variation in the prevalence of epilepsy and the provision of health care for patients with epilepsy across the different regions of Sweden.
authors.affiliation: Department of Economics, University of Gothenburg, Gothenburg, Sweden; Centre for Health Economics at University of Gothenburg, Gothenburg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Bolin
authors.forename: F
authors.initials: F
authors.lastname: Berggren
authors.forename: A-M
authors.initials: AM
authors.lastname: Landtblom
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D017281:Cost of Illness; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology
keywords: anti-epileptic drug utilization; anti-epileptic drugs; epilepsy; regional epilepsy prevalence