QI initiative cuts health care use in children with epilepsy

(HealthDay)—A quality improvement (QI) initiative can reduce emergency department and health care utilization for children with epilepsy, according to a report published online Jan. 20 in Pediatrics.

Anup D. Patel, M.D., from the Nationwide Children's Hospital in Columbus, Ohio, and colleagues aimed to decrease seizure-related emergency department visits by 20 percent, from a baseline of 17 to 13.6 visits per month per 1,000 patients. They used the Institute for Healthcare Improvement model to develop a QI project, with a defined outcome to decrease emergency department utilization for children with epilepsy. They determined the rate of emergency department visits and unplanned hospitalizations for epilepsy patients and associated health care costs.

The researchers observed a 28 percent reduction in emergency department visits 19 months after implementation of the interventions (from 17 to 12.2 visits per month per 1,000 patients; P < 0.0001). There was a 43 percent reduction in the average number of inpatient hospitalizations (from seven to four admission per month per 1,000 patients; P < 0.0001). There were decreases in health care claims paid, with reductions of $115,200 for emergency department visits and $1,951,137 for hospitalizations.

"Applying QI methodology was highly effective in reducing emergency department utilization and unplanned hospitalizations for children with epilepsy at a free-standing children's hospital," the authors write.

One author disclosed financial ties to the biopharmaceutical industry.