title: The health, education, and social care costs of school-aged children with active epilepsy: A population-based study.
abstract: OBJECTIVE
  To provide data on the health, social care, and education costs of active childhood epilepsy and factors associated with these costs over an 18-month period in a population-based sample.
  
  
  METHODS
  The Children with Epilepsy in Sussex Schools (CHESS) study is a population-based study involving school-aged children (5-15 years) with active epilepsy (taking one or more antiepileptic drug and/or had a seizure in the last year) in a defined geographical area in England. Clinical data were collected on 85 children (74% of eligible population) who underwent comprehensive psychological assessment. Health, education, and social care resource use was collected retrospectively over an 18-month period. Regression analysis was used to identify variables associated these with costs.
  
  
  RESULTS
  The mean (standard deviation) 18-month cost of health care for a child with active epilepsy was £3,635 (£5,339), with mean education and social care cost of £11,552 (£8,937) and £1,742 (£8,158), respectively, resulting in total mean costs per participant of £16,931 (£14,764). Health care costs were significantly associated with seizure frequency and etiology (all p-values < 0.05). Combined health care, social care, and education costs were significantly related to cognitive impairment (intelligence quotient [IQ] <85) and seizure frequency (p < 0.05). The mean cost of health care, social care, and education over 18 months for participants with cognitive impairment was £23,579 (95% confidence interval [CI] £16,489-£30,670) compared to £7,785 (95% CI £4,943-£10,627) for those without impairment.
  
  
  CONCLUSIONS
  Active childhood epilepsy has significant health, social care, and education costs. This is the first study to comprehensively document the economic impact on these sectors as well as factors associated with these costs. When caring for children with epilepsy in England, costs incurred by education and social care sectors are approximately four times the costs incurred by the health care sector. Increased costs were associated with cognitive impairment (IQ <85) and weekly or greater seizure frequency.
authors.affiliation: Research Department of Primary Care & Population Health, University College London, London, United Kingdom.
authors.forename: Rachael M
authors.initials: RM
authors.lastname: Hunter
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey, United Kingdom.|Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Colin
authors.initials: C
authors.lastname: Reilly
authors.affiliation: Child Development Centre, Crawley Hospital, Crawley, West Sussex, United Kingdom.
authors.forename: Patricia
authors.initials: P
authors.lastname: Atkinson
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey, United Kingdom.|Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.|Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom.
authors.forename: Krishna B
authors.initials: KB
authors.lastname: Das
authors.affiliation: Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gillberg
authors.affiliation: Muir Maxwell Epilepsy Centre, Edinburgh Neurosciences, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Chin
authors.affiliation: Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.|Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom.|College of Medicine, University of Vermont, Burlington, Vermont, U.S.A.
authors.forename: Rod C
authors.initials: RC
authors.lastname: Scott
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey, United Kingdom.|Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom.
authors.forename: Brian G R
authors.initials: BG
authors.lastname: Neville
authors.affiliation: Department of Applied Health Research, University College London, London, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004493:Education / Q000191:economics*; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D066252:Sociological Factors; D013334:Students
keywords: Cognition; Economic; Education; Health; Social care