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Does adherence to epilepsy quality measures correlate with reduced epilepsy-related adverse hospitalizations? A retrospective experience.
Ladner, Travis R; Morgan, Clinton D; Pomerantz, Daniel J; Kennedy, Vanessa E; Azar, Nabil; Haas, Kevin; Lagrange, Andre; Gallagher, Martin; Singh, Pradumna; Abou-Khalil, Bassel W; Arain, Amir M.
Afiliación
  • Ladner TR; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Morgan CD; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Pomerantz DJ; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Kennedy VE; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Azar N; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Haas K; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Lagrange A; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Gallagher M; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Singh P; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Abou-Khalil BW; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
  • Arain AM; Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
Epilepsia ; 56(5): e63-7, 2015 May.
Article en En | MEDLINE | ID: mdl-25809720
In 2011, the American Academy of Neurology (AAN) established eight epilepsy quality measures (EQMs) for chronic epilepsy treatment to address deficits in quality of care. This study assesses the relationship between adherence to these EQMs and epilepsy-related adverse hospitalizations (ERAHs). A retrospective chart review of 475 new epilepsy clinic patients with an ICD-9 code 345.1-9 between 2010 and 2012 was conducted. Patient demographics, adherence to AAN guidelines, and annual number of ERAHs were assessed. Fisher's exact test was used to assess the relationship between adherence to guidelines (as well as socioeconomic variables) and the presence of one or more ERAH per year. Of the eight measures, only documentation of seizure frequency, but not seizure type, correlated with ERAH (relative risk [RR] 0.343, 95% confidence interval [CI] 0.176-0.673, p = 0.010). Among patients in the intellectually disabled population (n = 70), only review/request of neuroimaging correlated with ERAH (RR 0.128, 95% CI 0.016-1.009, p = 0.004). ERAHs were more likely in African American patients (RR 2.451, 95% CI 1.377-4.348, p = 0.008), Hispanic/Latino patients (RR 4.016, 95% CI 1.721-9.346, p = 0.016), Medicaid patients (RR 2.217, 95% CI 1.258-3.712, p = 0.009), and uninsured patients (RR 2.667, 95% CI 1.332-5.348, p = 0.013). In this retrospective series, adherence to the eight AAN quality measures did not strongly correlate with annual ERAH.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adhesión a Directriz / Epilepsia / Hospitalización / Neurología Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Epilepsia Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adhesión a Directriz / Epilepsia / Hospitalización / Neurología Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Epilepsia Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos