title: Health care charges for youth with newly diagnosed epilepsy.
abstract: OBJECTIVE
  To estimate first-year health care charges for youth with newly diagnosed epilepsy seen within an interdisciplinary pediatric epilepsy team and examine demographic, clinical, and psychosocial predictors of annual charges.
  
  
  METHODS
  Retrospective chart review was conducted to extract medical, hospital, and physician billing data from the year following an epilepsy diagnosis for 258 patients (aged 2-18 years) seen in a New Onset Seizure Clinic between July 2011 and December 2012. Descriptive statistics were used to estimate per-patient total first-year charges and health care utilization patterns (e.g., hospitalizations, emergency department visits, outpatient visits). Univariate analyses examined differences in health care charges between demographic, clinical, and psychosocial factors. Predictors of health care charges were examined using hierarchical multiple regression analysis.
  
  
  RESULTS
  The estimated per-patient total first-year health care charge was $20,084 (95% confidence interval [CI] $16,491-$23,677). Charges were higher for patients who reported having seizures since diagnosis ($25,509; 95% CI $20,162-$30,856) and were associated with more antiepileptic drug side effects (r = 0.18; 95% CI 0.03-0.32). Controlling for demographic and clinical factors, poorer baseline health-related quality of life was associated with higher per-patient health care charges (B = -445.40; 95% CI -865 to -25).
  
  
  CONCLUSIONS
  The economic impact of pediatric epilepsy in the year following diagnosis is substantial. Cost reduction efforts would be optimized by improving seizure control and targeting health-related quality of life, an outcome amenable to behavioral intervention.
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. jamie.ryan@cchmc.org.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Ryan
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: McGrady
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Shanna M
authors.initials: SM
authors.lastname: Guilfoyle
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Katherine
authors.initials: K
authors.lastname: Junger
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Arnett
authors.affiliation: From the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use; D001521:Behavior Therapy / Q000191:economics / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007206:Individuality; D008297:Male; D055118:Medication Adherence; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010372:Pediatrics / Q000191:economics; D011237:Predictive Value of Tests; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000927:Anticonvulsants