Estimating the cost of admissions related to convulsive status epilepticus in the United States of America

Abstract

Purpose: To estimate the cost of admissions related to status epilepticus (SE) in the USA and to evaluate SE mortality.

Method: Descriptive retrospective study using national estimates from the KID's Inpatient Database (KID) for children and from the National Inpatient Sample (NIS) for adults for the years 2007-2012, the largest collection of all-payer, encounter-level hospital care data in the United States. The individual observation in this study is hospital admission.

Results: From a population of 186,013,640 admissions, a total of 184,500 admissions were related to SE. The median (p₂₅-p₇₅) cost of admissions related to SE was $7690 ($3893-$17,247) in the KID 2010-2012, $6529 ($3,370-$14,854) in the KID 2007-2009, $13,874 ($6699-$29,176) in the NIS 2012, $13,313 ($6,483-$28,598) in the NIS 2011, $12,999 ($6,366-$27,505) in the NIS 2010, $11,833 ($5721-$24,657) in the NIS 2009, $11,479 ($5,611-$24,326) in the NIS 2008, and $10,759 ($5493-$22,928) in the NIS 2007. Costs were more than two times higher for super-refractory SE admissions than for refractory SE admissions. Costs stratified by age followed an "U"-shaped distribution with higher costs in admissions of young children and older adults. Mortality ranged from 2.5% to 3% in children and from 12.7% to 14.9% in adults.

Conclusions: This study estimates the cost of admissions related to SE in the USA to be approximately $7000 in children and $13,000 in adults, and quantifies how costs markedly increase once SE becomes super-refractory.

Keywords: Cost; Epidemiology; Health services research; Status epilepticus.