Resident Geisinger Health System Danville, Pennsylvania, United States
Introduction: The estimated healthcare costs for an individual with epilepsy ranges from $10,192 to $47,862 annually. With various treatment options available, the cost can be an important consideration for patients when choosing treatment options. We aimed to analyze predictors of increased costs of epilepsy surgery in the United States population from 2016 to 2018.
Methods: The National Inpatient Sample database was utilized from 2016 to 2018. Patients were first selected by the diagnosis of medically refractory epilepsy, and then included if they underwent a surgical procedure. Surgical procedures analyzed were open resection, laser interstitial thermal therapy (LITT), radiotherapy (proton beam, stereotactic radiosurgery), and neurostimulation (deep brain stimulation, vagal nerve stimulation). Patients in the upper quartile of hospital costs were grouped and compared to all other patients.
Results: The average cost of LITT was $121,465, radiotherapy was $158,498, resection was $195,976, and neurostimulation at $216,221. Compared to LITT, there were higher odds of increased cost with resection (OR 2.3, 95% CI: 1.04-5.00), and neurostimulation (OR 5.5, 95% CI: 2.5-12.1). Being below the median income level (OR 0.73, 95% CI: 0.63-0.87), and receiving care at a teaching hospital (OR 0.62, 95% CI: 0.46-0.82) were associated with lower costs. Receiving care at a private hospital (OR 1.8, 95% CI: 1.4-2.2), increased length of stay (OR 12.7, 95% CI: 10.6-15.1), having diabetes (OR 1.5, 95% CI: 1.1-2.0), and hemorrhage (OR 2.3, 95% CI 1.1-4.4) were associated with higher costs (Figure 1).
Conclusion : The financial burden of surgical intervention is an important consideration for many patients with epilepsy. This data can assist in guiding discussions with patients when considering treatment options for their condition.
