Trends in Hospitalization and Readmission for Pediatric Epilepsy and Underutilization of Epilepsy Surgery in the United States

Background: Previous studies have shown the healthcare utilization for medically refractory epilepsy and epilepsy surgery until 2012 with disparities according to race/ethnicity and socioeconomic status. To extend these data and add other utilization information, we retrospectively investigated the nationwide trends in hospitalization and readmission during 2010-2015.

Method: We extracted data on inpatients who were diagnosed with epilepsy and those who received epilepsy surgery using the national inpatient sample and nationwide readmission database during 2010-2015. We estimated healthcare utilization related to pediatric epilepsy, the number of epilepsy surgeries, hospitalization rates and 30-day readmission rates.

Results: 100,000-120,000 children were hospitalized due to epilepsy each year. Hospitalization rates and 30-day readmission rates were 214.6-262.3 per 1000 patient-years and 72.4-78.0 per 1000 discharges, respectively. 1400-2000 children with epilepsy received epilepsy surgery, but the proportions of medically refractory epilepsy were estimated as 0.8 %-1.2 %. Disparities in patients receiving epilepsy surgery by race/ethnicity were observed during 2010-2012, but they were not after 2013. Children with higher household income levels had consistently higher proportions of receiving epilepsy surgery than those with lower levels. The hospitalization costs for epilepsy surgery were constant at $55,780-$60,813 after adjusting for healthcare cost inflation, whereas the cost for epilepsy were slightly elevated from $15,984 to $17,426.

Conclusions: We provide novel insights into the current healthcare utilization for epilepsy and epilepsy surgery. Although the disparity of epilepsy surgery seemed to be mitigated, surgery in children with medically refractory epilepsy was still underutilized.