ArticleEpilepsia2019
High health care costs in minority groups of older US Medicare beneficiaries with epilepsy.
Article in Epilepsia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- The role of social context in cognitive and neurobehavioural outcomes in epilepsy.Nature reviews. Neurology · 2026Review
- Ensuring Access to Neurologic Care: Challenges and Opportunities.Seminars in neurology · 2025Review
- Disparities in adherence and emergency department utilization among people with epilepsy: A machine learning approach.Seizure · 2023Article
- A framework for health equity in people living with epilepsy.Epilepsy research · 2022Review
- Accuracy of ICD-10-CM claims-based definitions for epilepsy and seizure type.Epilepsy research · 2020Article
- Delays and disparities in diagnosis for adults with epilepsy: Findings from U.S. Medicaid data.Epilepsy research · 2020Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo examine health care costs in diverse older Medicare beneficiaries with epilepsy.
methodsUsing 2008-2010 claims data, we conducted a longitudinal cohort study of a random sample of Medicare beneficiaries augmented for minority representation. Epilepsy cases (n = 36 912) had ≥1 International Classification of Diseases, Ninth Edition (ICD-9) 345.x or ≥2 ICD-9 780.3x claims, and ≥1 antiepileptic drug (AED) in 2009; new cases (n = 3706) had no seizure/epilepsy claims nor AEDs in the previous 365 days. Costs were measured by reimbursements for all care received. High cost was defined as follow-up 1-year cost ≥ 75th percentile. Logistic regressions examined association of high cost with race/ethnicity, adjusting for demographic, clinical, economic, and treatment quality factors. In cases with continuous 2-year data, we obtained costs in two 6-month periods before and two after the index event.
resultsCohort was ~62% African Americans (AAs), 11% Hispanics, 5% Asians, and 2% American Indian/Alaska Natives. Mean costs in the follow-up were ~$30 000 (median = $11 547; new cases, mean = $44 642; median = $25 008). About 19% white compared to 27% AA cases had high cost. AA had higher odds of high cost in adjusted analyses (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.11-1.29), although this was only marginally significant when adjusting for AED adherence (OR = 1.09, 95% CI = 1.01-1.18, P = 0.03). Factors associated with high cost included ≥1 comorbidity, neurological care, and low AED adherence. Costs were highest at ~$17 000 in the 6 months immediately before and after the index event (>$29 000 for new cases). SIGNIFICANCE: The financial sequelae of epilepsy among older Americans disproportionally affect minorities. Studies should examine contributors to high costs.
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