Long-Term Health Care Utilization Among Mothers of Children with Epilepsy - Including Psychiatric and Surgical
Malene Risager Lykke1, Katalin Veres1, Erzsébet Horváth-Puhó1
1Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Purpose:
Mothers of children with epilepsy (MCE) face elevated risks of psychological stress and psychiatric disorders, yet their overall health care utilization post-diagnosis remains underexplored. Understanding these patterns may inform more integrated, evidence-based care for affected families.
Patients And Methods:
A population-based cohort study using national health registry data in Denmark. From 1990 to 2017, 18,775 MCE were matched on maternal age, gestational age, child's sex and age at epilepsy diagnosis with up to 10 mothers without a child diagnosed with epilepsy (n = 188,630) and followed until 2018. Period prevalence was calculated as the proportion of MCE health care utilization (HCU). We compared period prevalence of health care utilization (HCU)-including primary care, inpatient, outpatient, psychiatric, and surgical contacts-between MCE and matched comparators using modified Poisson regression to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Mean annual HCU was visualized, and rate ratios were derived via negative binomial regression. Analyses were stratified by follow-up periods: 0-5, 6-10, and 11-20 years post-index.
Results:
Over 20-years' follow-up, MCE showed higher HCU than comparators across all services except primary care, which remained comparable. The RR of outpatient visits and surgical care contacts were slightly increased over the follow-up period. The risk of using psychiatric services was higher for MCE compared to the comparison cohort and increased over time, being 35% higher during the period of 11-20 years of follow-up (RR11-20 years = 1.35 [95% CI 1.18-1.39]). The rate of HCU was increased for MCE compared to the comparison cohort across services, except for psychiatric services, which was comparable for MCE and the reference cohort.
Conclusion:
Mothers of children with epilepsy had more health care use across hospital services compared with matched mothers of children without epilepsy, regardless of the child's age at diagnosis. These findings underscore the need for proactive mental health support and integrated care planning for mothers to mitigate long-term psychological burden.
