Managed Care Organizations Evaluate Trends in Epilepsy to Provide Better Care

Computer algorithms were used in a recent study to identify the prevalence and incidence of epilepsy, and epilepsy-related mortality of patients in a managed care organization (MCO). Data showed that these tools were successful in identifying these trends and were useful in making informed decisions affecting the health care needs and quality of life for epilepsy patients.

“It is possible in MCOs to identify prevalent and incident cases from existing management information systems data for monitoring disease burden and developing disease management programs,” states E. Wayne Holden, Ph.D., lead author of the study.

Systems already do exist that utilize the existing data in MCOs but there is a need for specific data analysis related to epilepsy due to the unique and contributing factors such as seizures, risk factors, and demographics. The algorithms developed for this study were especially sensitive to determine epilepsy prevalence, incidence and mortality in an MCO population, helping administrators to develop and focus interventions and assess the impact of quality-improvement programs. The best model correctly classified 90% of the cases in the study.

Mortality rates are significantly higher for individuals with epilepsy, about 2-3 times that of the average population. A crucial step in administering interventions to improve quality of life and health is the accurate identification of patients. Researchers found that determining incidence in an MCO is particularly challenging due to the constant ebb and flow of members. Preexisting diagnoses were often missed in new patient members and often pertinent data for epilepsy cases were not collected.