Emergency Department Utilization among Pediatric Patients with Epilepsy in Texas
Background: The objective of this study was to examine the distribution of emergency department (ED) visits among pediatric epilepsy patients in Texas aged birth-17 years for the calendar year 2015, and to evaluate differences between ED visits that did or did not result in hospitalization. Patients with HIV, alcohol, or drug use were excluded due to data reporting restrictions. We examined differences by socio-demographic factors such as age, sex, race, ethnicity, primary payment source, patient county type, patient ZIP code median income; pediatric complex chronic condition as clinical factor; and hospital specialty type as facility characteristic. Methods: The Texas Health Care Information Collection dataset for the year 2015 was used to obtain epilepsy related emergency department visits that did or did not result in hospitalization. The outcome variable was whether an ED visit resulted in hospitalization. Univariate analysis was performed to determine the association of individual factors with the binary outcome variable. Multilevel mixed-effects logistic regression was performed using significance level alpha at 0.05. The unit of analysis was an ED encounter. Results: A total of 8,027 epilepsy-related ED visits were reported in Texas for 2015. Of these, 6,489 ED visits did not result in hospitalization and 1,538 ED visits resulted in hospitalization. ED visits for children with pediatric complex chronic conditions were less likely to result in hospitalization than for children without pediatric complex chronic condition. Conclusion: Factors associated with an increased likelihood of hospitalization included age and primary payment source. Knowledge of emergency department utilization from this study can help enable improvements in access to care among children with epilepsy in Texas. Study results may help inform providers to implement family education programs for the clinical symptoms management in epilepsy care. Further study is needed to assess the ED utilization by types of epilepsy and develop care pathways specific to pediatric patients.
Amin, Shirali Samirkumar, "Emergency Department Utilization among Pediatric Patients with Epilepsy in Texas" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10811447.