Health resource use in epilepsy: Significant disparities by age, gender, and aboriginal status

Epilepsy imposes a significant burden on society. The objective of this study was to estimate health resource utilization (HRU) over a 1-year period in epilepsy patients, using administrative databases.

Three administrative databases (inpatient, emergency, and physician claims) were used to identify epilepsy cases. HRU variables included general physician (GP) and emergency (ER) visits, physician billings, hospitalizations, and length of stay (LOS). Logistic regression was used to determine the association between demographic variables and HRU variations.

Among the 1,431 patients with a mean age of 37.5 +/- 17.3 years, 56 (4%) were aboriginal. Ninety-six percent of patients saw a GP or a specialist (outpatient visit), 12% were hospitalized, and 8% visited the ER. Younger patients were more likely to see a neurologist (OR = 1.7, 95% CI 1.3-2.3), visit the ER (OR = 4.9, 95% CI 3.2-7.4), or be hospitalized (OR = 2.9, 95% CI 2.0-4.3). Females were less likely to see a GP but more likely to see a neurologist. Aboriginals were more likely than nonaboriginals to visit the ER (OR = 2.3, 95% CI 1.1-5.0) or be hospitalized (OR = 2.8, 95% CI 1.5-5.1) but less likely to see a neurologist (OR = 0.3, 95% CI 0.2-0.6). Welfare status and residence location (urban vs. rural) were not associated with HRU level.

We demonstrated the feasibility of using administrative databases to assess HRU in epilepsy. We also uncovered disparities in HRU by age, gender, and by aboriginal status, suggesting possible internal or external barriers to specialized care in some groups.