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The health, education, and social care costs of school-aged children with active epilepsy: A population-based study

Journal article
Authors R. M. Hunter
Colin Reilly
P. Atkinson
K. B. Das
Christopher Gillberg
R. F. Chin
R. C. Scott
B. G. R. Neville
S. Morris
Published in Epilepsia
Volume 56
Issue 7
Pages 1056-1064
ISSN 0013-9580
Publication year 2015
Published at Gillberg Neuropsychiatry Centre
Pages 1056-1064
Language en
Links dx.doi.org/10.1111/epi.13015
Keywords Economic, Health, Social care, Education, Cognition, CHILDHOOD-ONSET EPILEPSY, OF-LIFE OUTCOMES, DISORDERS, ADOLESCENTS, PREVALENCE, UK, Clinical Neurology
Subject categories Neurology

Abstract

ObjectiveTo 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. MethodsThe Children with Epilepsy in Sussex Schools (CHESS) study is a population-based study involving school-aged children (5-15years) 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. ResultsThe mean (standard deviation) 18-month cost of health care for a child with active epilepsy was 3,635 (5,339) pound, with mean education and social care cost of 11,552 pound (8,937) pound and 1,742 pound (8,158) pound, respectively, resulting in total mean costs per participant of 16,931 pound (14,764) pound. 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 18months for participants with cognitive impairment was 23,579 pound (95% confidence interval [CI] 16,489- pound 30,670) pound compared to 7,785 pound (95% CI 4,943- pound 10,627) pound for those without impairment. SignificanceActive 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.

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