Abstracts

The Financial Impact of Referral to a Specialized Outpatient Functional Seizure Clinic

Abstract number : 3.384
Submission category : 13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year : 2023
Submission ID : 1153
Source : www.aesnet.org
Presentation date : 12/4/2023 12:00:00 AM
Published date :

Authors :
Presenting Author: Meagan Bean, MPHc – University of Colorado, Non-Epileptic Seizure (NES) Clinic

Meagan Watson, MPH, MBAc – Program Manager, Neurology, University of Colorado, Non-Epileptic Seizure (NES) Clinic; Laura Strom, MD, FAES – Medical Director, Neurology, University of Colorado, Non-Epileptic Seizure (NES) Clinic

Rationale:
Patients with functional seizures (FS) utilize healthcare at high rates and contribute to high healthcare costs. Access to treatment for FS is limited but has been shown to decrease inappropriate emergency department (ED), inpatient care, and hospital readmissions. In this study we assess the financial impact of referral to a specialized, outpatient FS treatment clinic on ED and inpatient visits, their associated charges, and adjusted payments.

Methods:
We collected data from 100 consecutive patients referred to the University of Colorado FS Clinic between July 2019 to December 2021. Hospital data were obtained via the electronic medical record. Outcomes were total ED and inpatient visits, charges, and payments one year before versus one year after referral. Wilcoxon signed-rank test was used to analyze before and after referral measures.

Results:
Ninety-four patients were included for analysis: 79% were female, 52% were on Medicaid, mean age was 41 (SD 1.36), and 20% had dual epilepsy and FS diagnosis. After-referral total (ED + inpatient) visits differed significantly than before-referral total visits (mean= 1.44 (SD 3.52) vs. 1.83 (SD 3.52), p = 0.0452). The same test was performed for total charges after and before referral ($15,551.44 [SD $38,711.75] vs. $30,256.62 [SD $81,589.31], p = 0.0148); and for total payments after and before referral ($2,468.97 [SD $6,682.32] vs. $5,199.11 [SD $15,084.15], p = 0.0086).

Conclusions:
Referral to a specialized outpatient FS clinic for patients with FS significantly reduced ED and inpatient visits and associated costs. Hospitals should implement policies to support efficient care pathways to gold-standard treatment for these patients.

Funding:
None

Health Services (Delivery of Care, Access to Care, Health Care Models)