The long-term economic benefits of surgery outweigh the initial cost in children with epilepsy

February 22, 2022

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According to a Canadian study published in Neurology.

“While there is a plethora of evidence supporting the benefits of pediatric epilepsy surgery on improving seizure control at the patient level, less is known about the economic impact on the healthcare system,” Elysa Widjaja, MD, MPH, from the Institute of Health Policy, Management and Evaluation at the University of Toronto, and colleagues wrote.

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The researchers sought to assess whether improved seizure control after surgery could lead to decreased long-term health care resource use and costs, compared to medical therapy, in children with drug-resistant epilepsy.

They looked at more than 600 Canadian children who were evaluated for epilepsy surgery and treated with either surgery (n=372) or medical therapy (n=258) from 2003 to 2018 at the Hospital for Sick Children in Toronto.

Researchers assigned patients to preoperative, surgical, short-term (first 2 years), medium-term (2-5 years), and long-term (5 years or more) postoperative care phases, based on trajectory of treatment, and assessed phase-specific and cumulative long-term health care costs. Costs have been converted from Canadian dollars to US dollars based on the value of the currency in 2018.

The results showed that costs were higher for surgical patients than for medical patients for the preoperative, surgical and acute care phases, while costs were lower for surgical patients for the intermediate care and postoperative phases. long duration.

For the surgical cohort, costs were highest for surgery followed by the preoperative care phase, with hospitalizations accounting for the highest costs. Conversely, in the medical cohort, costs increased gradually from the preoperative phase to the long-term care phase. Cumulative costs were higher for surgical patients than for medical patients during the first 7 years after surgery, but the trend reversed after 8 years.

“We anticipate that our findings are generalizable to other centers outside of Canada, in that the high initial cost of epilepsy surgery would be offset by the lower costs of the intermediate and long-term care phases. , so the long-term cumulative costs of surgical patients would be lower than medical patients,” Widjaja and colleagues wrote. “However, the magnitude of healthcare costs for surgical and medical patients in our study would be different from other countries due to differences in healthcare systems.”

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