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Inpatient medical cost of status epilepticus in children: A national-wide, multicenter study from China
Tianqi Wang1, Ji Wang1, Guoping Lu2
1Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Insights
Pediatric status epilepticus (SE) in China incurs significant inpatient medical costs, averaging $1175.5. Longer hospital stays and specific etiologies are key cost drivers.
Area of Science:
- Pediatric Neurology
- Health Economics
- Public Health
Background:
- Status epilepticus (SE) in children represents a significant healthcare burden.
- Understanding the economic impact of pediatric SE is crucial for resource allocation and healthcare policy in China.
Purpose of the Study:
- To determine the inpatient medical costs associated with pediatric SE in China.
- To identify factors influencing these costs through a nationwide, multicenter study.
Main Methods:
- Retrospective analysis of 4041 pediatric SE inpatients from 44 hospitals across China (2013-2015).
- Inclusion of data on inpatient medical costs, length of hospital stay (LOS), etiology, and treatments.
- Statistical analysis, including multiple linear regression, to identify cost-associated factors.
Main Results:
- The median inpatient medical cost for pediatric SE was $1175.5.
- Higher costs were associated with status epilepticus with refractory epilepsy (SRSE) ($3865.6) versus non-refractory SE (N-SRSE) ($1048.6).
- Length of hospital stay (LOS) > 7 days, diagnostic examinations, treatment equipment/procedures, and medications significantly increased costs. Acute symptomatic etiology, particularly central nervous system (CNS) infection, led to higher costs compared to prolonged febrile seizures (PFS) or idiopathic/cryptogenic epilepsy.
Conclusions:
- Pediatric SE is a costly condition in China, with a median inpatient cost of $1175.5.
- Factors significantly impacting costs include LOS, etiology (e.g., CNS infection, PFS), diagnostic procedures, treatments, and medications.
- Identifying these cost drivers can inform targeted interventions to manage the economic burden of pediatric SE.
Objectives:
To describe the inpatient medical cost during hospitalization in children with status epilepticus (SE) and identify factors associated with the cost by a nationwide, multicenter study in China.
Materials & Methods:
We retrospectively identified pediatric inpatients with SE form Hospital Information System (HIS) of 44 hospitals in 27 provinces in China between 2013 and 2015. Inpatient medical cost and factors associated with the cost were analyzed.
Results:
A total of 4041 children diagnosed with SE with inpatient medical cost were enrolled in the present study. The median age at admission was 2.9 (range 0.1-18) years, and 2271 patients were male (56.2%). The median inpatient medical cost of children with SE was $1175.5 (665.1-2320.6). The median inpatient medical cost was $3865.6 (1837.4-8210.4) in children with SRSE and $1048.6 (619.8-1865.4) in those with N-SRSE (p < 0.0001). Children with length of hospital stay (LOS) > 7 showed a much higher inpatient medical cost than those with LOS ≤ 7 day ($2300.7 vs. $767.2, p < 0.0001). Regarding different etiologies, children with acute symptomatic etiology showed the highest median inpatient medical cost of $1681.1 (901.0-3699.6), in which children with central nervous system (CNS) infection reported $2606.0 (1380.0-5016.1) and prolonged febrile seizures (PFS) reported $909.8 (649.3-1322.0). Additionally, children with idiopathic/cryptogenic etiology reported a medical cost of $923.2 (548.9-1534.5). Multiple linear regression analysis of cost-driving factors revealed LOS > 7, examinations, treatment equipment and procedures, and treatment medicines were independently associated with a higher inpatient medical cost (R2 = 60.91). In addition, PFS and idiopathic/cryptogenic epilepsy etiology were independently associated with a lower cost.
Conclusions:
SE in children was a cost intensive disease in China with a median inpatient medical cost of $1175.5. LOS, etiology and examinations, treatment equipment and procedures, and treatment medicines were significantly associated with inpatient medical cost.
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