Surgeon-Led Initiatives to Increase Access to Surgical Treatment of Epilepsy at an Academic Level 4 Epilepsy Center: An Observational Cohort Study.
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
received:
13
10
2021
accepted:
30
01
2022
pubmed:
7
4
2022
medline:
10
6
2022
entrez:
6
4
2022
Statut:
ppublish
Résumé
Underutilization of surgical treatment for epilepsy is multifactorial, and the multidisciplinary nature of caring for these patients represents a significant hurdle in expanding surgical treatment of epilepsy. To develop internal and external surgical referral relationships for patients with medically refractory epilepsy with the goal of improving access to care. To expand access to surgical epilepsy treatment at University of California (UC)-Irvine, 4 broad approaches focused on developing referral relationships and process improvement of surgical evaluation were undertaken in 2015 and 2016. The authors performed a retrospective review of all surgical epilepsy case referrals of the senior author from 2014 through 2020. Epilepsy surgical volume at UC-Irvine increased from an average of 5.2 cases annually to 32 cases in the first year (2015) of implementation. There was continued case volume growth from 2015 through 2020 to 52 procedures in the most recent year (P = .03). Hospital payments for epilepsy procedures increased from $1.09M in 2015 to $2.02M and $1.8M in 2019 and 2020 (P < .01), respectively, while maintaining a diverse payer mix. 79.4% of these patients did not have a previously established option for surgical epilepsy care. We outline strategies that level 4 epilepsy centers may use to strengthen collaborations and improve patient access for surgical epilepsy treatment. Increased collaboration can both improve the number of patients with epilepsy with access to specialized surgical care and produce reimbursement benefits for the centers caring for these patients, regardless of insurance source.
Sections du résumé
BACKGROUND
Underutilization of surgical treatment for epilepsy is multifactorial, and the multidisciplinary nature of caring for these patients represents a significant hurdle in expanding surgical treatment of epilepsy.
OBJECTIVE
To develop internal and external surgical referral relationships for patients with medically refractory epilepsy with the goal of improving access to care.
METHODS
To expand access to surgical epilepsy treatment at University of California (UC)-Irvine, 4 broad approaches focused on developing referral relationships and process improvement of surgical evaluation were undertaken in 2015 and 2016. The authors performed a retrospective review of all surgical epilepsy case referrals of the senior author from 2014 through 2020.
RESULTS
Epilepsy surgical volume at UC-Irvine increased from an average of 5.2 cases annually to 32 cases in the first year (2015) of implementation. There was continued case volume growth from 2015 through 2020 to 52 procedures in the most recent year (P = .03). Hospital payments for epilepsy procedures increased from $1.09M in 2015 to $2.02M and $1.8M in 2019 and 2020 (P < .01), respectively, while maintaining a diverse payer mix. 79.4% of these patients did not have a previously established option for surgical epilepsy care.
CONCLUSION
We outline strategies that level 4 epilepsy centers may use to strengthen collaborations and improve patient access for surgical epilepsy treatment. Increased collaboration can both improve the number of patients with epilepsy with access to specialized surgical care and produce reimbursement benefits for the centers caring for these patients, regardless of insurance source.
Identifiants
pubmed: 35384922
doi: 10.1227/neu.0000000000001961
pii: 00006123-202207000-00019
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
167-172Informations de copyright
Copyright © Congress of Neurological Surgeons 2022. All rights reserved.
Références
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