INTRODUCTION Clinical research has consistently established mental health conditions (MHCs) as frequent comorbidities of epilepsy. However, the extent of economic burden of comorbid MHC in patients with focal seizures has not been systematically investigated. This retrospective cohort analysis of health plan claims compared healthcare use and costs among adult patients with focal seizures with and without comorbid MHC. METHODS We utilized the Inovalon Medical Outcomes Research for Effectiveness and Economics (MORE2) Registry, longitudinal data from over 150 commercial, Medicare Advantage, and managed Medicaid health plans for the analysis, and identified a cohort of patients with focal (partial-onset) seizure with relevant ICD9/10 diagnosis codes with and without MHC. Mental health conditions were defined as diagnoses for anxiety, bipolar condition/mania, attention-deficit conduct condition, major depression, schizophrenia, and other psychotic conditions, and patients without MHC were propensity score-matched to patients with preexisting MHC on baseline patient characteristics. The assessment examined a series of outcomes, including 1) direct healthcare resource utilization and 2) total provider reimbursement. RESULTS Patients with preexisting MHC were more likely to receive adjunctive epilepsy therapy as well as broad-spectrum antiepileptic drugs/antiseizure medications (ASMs). Additionally, patients with focal seizures and MHC were significantly more likely to utilize high-cost healthcare services. The presence of MHC was associated with approximately 50% greater utilization of emergency department (ED), physician, and inpatient services. Consequently, healthcare expenditures were significantly higher among patients with MHC ($17,596 vs. $10,857; 62% higher, p < 0.001), with the trend consistent across all care settings. CONCLUSIONS This analysis illustrates the health service utilization and cost implications of MHC among patients with focal seizures. The data suggest that patients with MHC have a greater overall clinical burden, which may be associated with higher healthcare resource use and expenditures. Because of the potential burden and costs associated with MHC, neurologists should consider screening patients with focal seizures for mental health disorders to identify and initiate treatment for comorbid mental health disorders.

中文翻译：

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成年局灶性癫痫患者精神健康状况的增加负担

引言 临床研究一致认为精神健康状况 (MHC) 是癫痫的常见合并症。然而，尚未系统地研究局灶性癫痫患者合并 MHC 的经济负担程度。这项对健康计划索赔的回顾性队列分析比较了伴有和不伴有 MHC 的局灶性癫痫成年患者的医疗保健使用和费用。方法 我们利用 Inovalon 有效性和经济性医疗结果研究 (MORE2) 注册表、来自 150 多个商业、Medicare Advantage 和管理的 Medicaid 健康计划的纵向数据进行分析，并确定了一组局灶性（部分发作）癫痫患者带和不带 MHC 的相关 ICD9/10 诊断代码。心理健康状况被定义为焦虑的诊断，双相情感障碍/躁狂症、注意力缺陷行为疾病、重度抑郁症、精神分裂症和其他精神病以及没有 MHC 的患者在基线患者特征上与预先存在 MHC 的患者进行倾向评分匹配。评估检查了一系列结果，包括 1) 直接医疗资源利用和 2) 提供者总报销。结果 先前存在 MHC 的患者更有可能接受辅助癫痫治疗以及广谱抗癫痫药物/抗癫痫药物 (ASM)。此外，局灶性癫痫和 MHC 患者更可能使用高成本的医疗保健服务。MHC 的存在与约 50% 的急诊科 (ED)、医生和住院服务的利用率有关。最后，MHC 患者的医疗保健支出明显更高（17,596 美元对 10,857 美元；高 62%，p < 0.001），所有护理环境中的趋势一致。结论 该分析说明了 MHC 在局灶性癫痫患者中的卫生服务利用和成本影响。数据表明，MHC 患者的总体临床负担更大，这可能与更高的医疗资源使用和支出有关。由于与 MHC 相关的潜在负担和成本，神经科医生应考虑筛查局灶性癫痫患者的精神健康障碍，以确定并开始治疗共病精神健康障碍。结论 该分析说明了 MHC 在局灶性癫痫患者中的卫生服务利用和成本影响。数据表明，MHC 患者的总体临床负担更大，这可能与更高的医疗资源使用和支出有关。由于与 MHC 相关的潜在负担和成本，神经科医生应考虑筛查局灶性癫痫患者的精神健康障碍，以确定并开始治疗共病精神健康障碍。结论 该分析说明了 MHC 在局灶性癫痫患者中的卫生服务利用和成本影响。数据表明，MHC 患者的总体临床负担更大，这可能与更高的医疗资源使用和支出有关。由于与 MHC 相关的潜在负担和成本，神经科医生应考虑筛查局灶性癫痫患者的精神健康障碍，以确定并开始治疗共病精神健康障碍。