Annual Meeting Abstracts: View

  • (Abst. 1.207), 2012
  • COMMON COMORBIDITIES IN WOMEN AND MEN WITH EPILEPSY AND THE RELATIONSHIP BETWEEN NUMBER OF COMORBIDITIES AND HEALTH PLAN PAID COSTS IN 2010
  • Authors: A. N. Wilner, A. Soucy, B. Sharma, A. Krueger, A. Thompson
  • Content:

    Rationale: Epilepsy affects more than 2 million people in the United States (U.S.). Comorbidities associated with epilepsy increase heath care costs and complicate epilepsy diagnosis and management. Identifying and treating comorbidities is one of the gaps in epilepsy care identified in the Institute of Medicine's 2012 epilepsy report. Our objectives were to determine 1) the prevalence of common comorbidities by gender, and 2) the relationship between the number of comorbidities and health plan paid costs for each gender. Methods: Data came from eight commercial health plans located in different parts of the U.S. that contract with Accordant Health Services (AHS) for care management of members with rare and/or chronic conditions. Members with epilepsy were identified using an in-house algorithm that utilizes ICD-9 diagnosis codes and pharmacy utilization. The presence of comorbidity-specific diagnosis codes for 29 comorbidities was examined in health insurance claims for the year 2010. The top 10 most prevalent comorbidities were identified for women and men. The health plan paid amount per member per month ($, PMPM) was summarized by gender and by number of comorbidities for each gender. The correlations between number of comorbidities and health care costs were examined separately for women and men. Results: The study population consisted of N=6,621 individuals with epilepsy (52% women; 48% men). The average age was 36 years for women and 34 years for men. More women (50%) than men (43%) had one or more of the 29 comorbidities specified (P<0.05). For women, the top 10 comorbidities and the prevalence rates were psychiatric diagnosis (16%), hypertension (12%), asthma (11%), hyperlipidemia (11%), headache (7%), diabetes (6%), UTI (5%), hypothyroidism (5%), anemia (5%) and migraine (4%). For men, the top 10 comorbidities and the prevalence rates were psychiatric diagnosis (15%), hyperlipidemia (12%), hypertension (12%), asthma (8%), diabetes (5%), headache (4%), cancer (4%), CAD (3%), anemia (3%) and GERD (3%). The health plan paid cost (PMPM±SEM) was $1,045±61 for women and $1,052±63 for men, but these costs were statistically similar (P>0.05). The correlation between comorbidity burden and the health plan paid cost PMPM was r=+0.22 (P=<0.001) for women and r=+0.26 (P=<0.001) for men. The rate of increase in the health care cost PMPM ($) with an increasing number of comorbidities was greater for men than for women (P<0.05). Conclusions: More women than men with epilepsy had one or more comorbidities (P<0.05). Psychiatric diagnosis, hyperlipidemia, hypertension, asthma, diabetes, headache and anemia were among the top 10 comorbidities common for women and men. The average health plan paid cost was not different by gender (P>0.05). The number of comorbidities was positively and significantly associated with the health plan paid cost for both women and men (P<0.05). The rate of increase in the health care cost PMPM ($) with increasing comorbidity burden was greater for men than for women (P<0.05).
  • Figures:
  • Figure 1