Healthcare resource burden of newly diagnosed epilepsy in the US low-income elderly population

Objective: To assess the incremental and relative healthcare resource burden of new-onset epilepsy among the concurrently old and medically indigent. Design: A retrospective cohort study employing Arizona Medicaid claims data years from 2008 through 2010. Setting: The elderly poor; dually eligible beneficiaries. Subjects: To qualify as a patient with newly diagnosed epilepsy, patients were required to (1) be at least 65 years of age; (2) be continuously enrolled in Arizona Medicaid for at least 12 months; (3) have seizure-related healthcare claims; (4) no claims with a diagnosis code of 345.x1; and (5) have a one-year clean period without evidence of epilepsy or seizure disorder. Measurements: The outcome variables assessed included total monthly healthcare, inpatient, outpatient, and prescription costs to Arizona Medicaid, incidence rate of inpatient stay, and incidence rate of physician visits. Results: A total of 472 newly diagnosed patients (15% age ≥ 85, 64% female) and 60,256 controls (22% age ≥ 85, 65% female) were identified for this analysis. Matched cases had 2.78, 3.82, 2.70, 1.55, 2.72, and 1.28 times greater monthly total healthcare costs (P < 0.001), inpatient costs (P < 0.001), outpatient costs (P < 0.001), prescription drug costs (P = 0.149), inpatient visits (P < 0.001), and physician visits (P = 0.377) compared with their counterpart. Incremental monthly total healthcare costs in patients with newly diagnosed epilepsy were on average 2066 (SE = 432) US dollars. Conclusions: The elderly poor with newly diagnosed epilepsy in the US had significantly greater healthcare resource use compared with those without epilepsy.