Abstracts

RATIONALE: Cost effectiveness and cost-benefit analyses of epilepsy surgery could be influenced by change in income after surgery. We performed an analysis to determine how earned income changes after surgery, how seizure control affects per capita income.
METHODS: 250 patients who had temporal lobectomy were evaluated in this study. All had more than 3 years follow-up, IQ [gt] 70, were [gt] 18 years old at surgery, and had completed their education. For each patient, occupation and number of hours worked per week before and after surgery was registered. Each patient was assigned an annual income before and after surgery based upon the U.S. Bureau of Labor Statistics 1998 Occupational Employment Statistics Survey. Pre- and post-operative per capita income were compared and related to postoperative seizure control.
RESULTS: Before surgery, 117 patients worked full time and 20 patients worked part time. Mean per capita annual income before surgery for the entire cohort was $17,456. After surgery, 140 patients worked full time and 32 patients worked part time. For the entire cohort, mean per capita income after surgery was $21,388, an increase of 22.5%. After surgery, 123 patients were completely seizure free (93 employed), 47 patients were currently seizure free but had some postoperative seizures (37 employed), and 80 patients had seizures in the last follow-up year (42 employed). Per capita earnings for just the employed subjects was related to postoperative seizure control; annual per capita income in each of these three groups was $32,808, $29,414 and $28,751, respectively.
CONCLUSIONS: Per capita annual income increases after anterior temporal lobectomy. Annual income after surgery is related to seizure control, even among employed patients. Factoring the increase in per capita income in economic analyses would substantially reduce estimates of cost of epilepsy surgery.