Health resource utilization varies by comorbidities in children with epilepsy

Klajdi Puka, Mary Lou Smith, Rahim Moineddin, O. Carter Snead, Elysa Widjaja*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objectives: Comorbidities in adults with epilepsy have been shown to significantly increase health resource utilization (HRU). The current study aimed to determine whether a similar association exists among children with epilepsy in a universal health insurance system. Methods: Health administrative databases in Ontario, Canada were used to evaluate the frequency of neurologist visits, emergency department (ED) visits, and hospitalizations. We evaluated the association between HRU and comorbidities, including depression, anxiety, learning disability, attention deficit hyperactivity disorder (ADHD), and autistic spectrum disorder (ASD), adjusting for age, sex, residence, and socio-economic status. Results: The frequency of neurology visits was increased by comorbid depression, ASD, and learning disability (adjusted relative risk [aRR] = 1.29-2.07; p < .01). The frequency of ED visits was increased by all comorbidities (aRR = 1.26-2.83; p < .0001). The frequency of hospitalizations was increased by comorbid depression, anxiety, ASD, and learning disability (aRR = 1.77-7.20; p < .0001). Learning disability had the largest impact on HRU. For each additional comorbidity, the frequency of neurology visits, ED visits, and hospitalizations increased by 1.64 to 3.16 times (p < .0001). Conclusions: Among children with epilepsy, mental health and developmental comorbidities were associated with increased HRU, and different comorbidities influenced different types of HRU. In addition, we highlight the importance of identifying and managing these comorbidities, as they increased the risks of costly HRU such as ED visits and hospitalizations.

Original languageEnglish (US)
Pages (from-to)151-154
Number of pages4
JournalEpilepsy and Behavior
StatePublished - Apr 1 2016


  • Developmental comorbidity
  • Health service utilization
  • Mental health
  • Pediatric
  • Population study

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Behavioral Neuroscience


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