Related Experiment Video
Updated: Aug 24, 2026
Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Impact of pediatric epilepsy surgery on healthcare resource use
Alex S Aguirre1, Daan A Pijs2, Iván Sánchez Fernández3
1Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Insights
Epilepsy surgery significantly reduces healthcare resource use in pediatric patients with drug-resistant epilepsy, particularly when no further surgeries are needed. These findings hold true across various insurance types, races, and ethnicities.
Area of Science:
- Pediatric Neurology
- Health Economics
- Medical Informatics
Background:
- Drug-resistant epilepsy affects numerous children, necessitating advanced treatment strategies.
- Epilepsy surgery is a critical intervention for managing refractory cases.
- Understanding the economic impact of epilepsy surgery is vital for healthcare planning.
Purpose of the Study:
- To quantify changes in healthcare resource utilization before and after epilepsy surgery in pediatric patients.
- To analyze these changes stratified by surgery type, insurance, race, and ethnicity.
Main Methods:
- Retrospective analysis of the Pediatric Health Information System (PHIS) database (2004-2024).
- Focus on healthcare resource use as the primary outcome measure.
- Inclusion of 1288 pediatric patients undergoing 1538 epilepsy surgeries.
Main Results:
- Epilepsy surgery led to significant reductions in hospital admissions, hospital days, and overall healthcare costs per person-year.
- The median cost of epilepsy surgery was substantial, but post-surgery savings were evident.
- Reductions were more pronounced in patients requiring a single surgery compared to those needing multiple procedures.
- Healthcare resource use decreased similarly across different insurance types, races, and ethnicities, with noted variations for specific initial surgical approaches like LITT or radiosurgery.
Conclusions:
- Epilepsy surgery offers a significant decrease in healthcare resource utilization for pediatric patients with drug-resistant epilepsy.
- The economic benefits are most substantial when patients do not require subsequent surgeries.
- The positive impact on resource utilization is consistent across diverse demographic and insurance groups.
Objective:
To quantify healthcare resource use before and after epilepsy surgery among pediatric patients with drug-resistant epilepsy, stratifying by type of surgery, type of insurance, race, and ethnicity.
Methods:
Retrospective descriptive study of the Pediatric Health Information System (PHIS) database in the period 2004-2024. Our main outcome was healthcare resource use.
Results:
1288 patients (median (p25-p75) age at first epilepsy surgery: 11.0 (6.8-15.3) years, 43% females) had a total of 1538 epilepsy surgeries. Although the median (p25-p75) cost of epilepsy surgery was high [$88,512 ($51,283-$145,159)], after epilepsy surgery (versus before epilepsy surgery) there was a decrease in number of hospital admissions per person-year [0.6 (0.2-1.3) versus 1.4 (0.8-2.4), p < 0.0001], days of hospital stay per person-year [1.5 (0.3-5.0) versus 4.4 (2.2-9.1), p < 0.0001], and total healthcare resource use per person-year [$15,571 ($4,465-$44,089) versus $28,100 ($14,723-$58,455), p < 0.0001]. Decreases in healthcare resource use were more pronounced among patients who required only one epilepsy surgery than in patients who needed subsequent epilepsy surgeries. Decreases in healthcare resource use were similar for all types of surgeries except when the first surgery was laser interstitial thermal therapy (LITT) or ablation or radiosurgery (mainly because many of these patients required subsequent surgeries), for all types of insurances, for all races, and for all ethnicities.
Conclusion:
Among pediatric patients with drug-resistant epilepsy, healthcare resource use substantially decreases after epilepsy surgery, especially when the patient does not require subsequent epilepsy surgeries. Results were similar for all types of insurance, for all races, and for all ethnicities.
