Impact of pediatric epilepsy surgery on healthcare resource use.

OBJECTIVE: To quantify healthcare resource use before and after epilepsy surgery among pediatric patients with drug-resistant epilepsy, stratifying by type of surgery, type of insurance, race, and ethnicity. METHODS: Retrospective descriptive study of the Pediatric Health Information System (PHIS) database in the period 2004-2024. Our main outcome was healthcare resource use. RESULTS: 1288 patients (median (p25-p75) age at first epilepsy surgery: 11.0 (6.8-15.3) years, 43% females) had a total of 1538 epilepsy surgeries. Although the median (p25-p75) cost of epilepsy surgery was high [$88,512 ($51,283-$145,159)], after epilepsy surgery (versus before epilepsy surgery) there was a decrease in number of hospital admissions per person-year [0.6 (0.2-1.3) versus 1.4 (0.8-2.4), p < 0.0001], days of hospital stay per person-year [1.5 (0.3-5.0) versus 4.4 (2.2-9.1), p < 0.0001], and total healthcare resource use per person-year [$15,571 ($4,465-$44,089) versus $28,100 ($14,723-$58,455), p < 0.0001]. Decreases in healthcare resource use were more pronounced among patients who required only one epilepsy surgery than in patients who needed subsequent epilepsy surgeries. Decreases in healthcare resource use were similar for all types of surgeries except when the first surgery was laser interstitial thermal therapy (LITT) or ablation or radiosurgery (mainly because many of these patients required subsequent surgeries), for all types of insurances, for all races, and for all ethnicities. CONCLUSION: Among pediatric patients with drug-resistant epilepsy, healthcare resource use substantially decreases after epilepsy surgery, especially when the patient does not require subsequent epilepsy surgeries. Results were similar for all types of insurance, for all races, and for all ethnicities.