Burden of disease of people with epilepsy during an optimized diagnostic Check for trajectory: costs and quality of life

Background: Diagnosing epilepsy can be lengthy and stressful, potentially leading to increased use of healthcare resources and a reduction in quality of life. Aim: This study aims to determine cost and quality of life before and after an optimized diagnostic procedure for people suspected of having epilepsy from a societal perspective with a follow-up of 12 months. In addition, this study aims to differentiate between people diagnosed with epilepsy during the follow-up of the study and the people who are diagnosed as not having epilepsy or for whom diagnosis is still uncertain. Methods: A questionnaire regarding the use of healthcare resources was used accompanied by the EQ-5D-3 L. Multiple imputations by chained equations with predictive mean matching was used to account for missing data. To investigate the uncertainty of the results, non-parametric bootstrapped (1000 times) was used. Results: In total, 116 people were included in the study. Total average costs per patient made in the previous 3 months had decreased from (sic)4594 before the optimized diagnostic trajectory to (sic)2609 in the 12 months after the optimized diagnostic trajectory. Healthcare costs were the largest expense group (52-66%) and had decreased significantly from baseline measurement to 12 months after baseline ((sic)2395 vs (sic)1581). Productivity costs had decreased from (sic)1367 to (sic)442 per 3 months. Total annual costs were similar between people diagnosed with epilepsy during the follow-up of the study and the people who are diagnosed as not having epilepsy or for whom diagnosis is still uncertain. Quality of Life had significantly increased over the course of 12 months from 0.80 to 0.84 (Dutch tariff). Discussion: This study indicates that an optimized diagnostic trajectory has positively influenced the use of healthcare resources and the quality of life in people with epilepsy. As chronic care patients make diverse costs, future research should identify the long-term costs after an optimized diagnostic trajectory for patients with epilepsy, possibly identifying patients who are at high risk of becoming high-cost users in the future for early intervention