Rozpoznawanie epilepsji i towarzyszące jej choroby u dzieci i młodzieży w programie Specjalistycznej Opieki Zdrowotnej dla Dzieci w Michigan
Epilepsy Ascertainment and Documented Comorbidity Among Children and Youth in Michigan’s Children’s Special Health Care Services Program
W skrócie
[Preprint - wstępne wyniki] Badacze przeanalizowali dane z programu opiekuńczego w Michigan dotyczące prawie 8500 dzieci i młodzieży z epilepsją w latach 2016–2022. Okazało się, że blisko 30 procent pacjentów miało udokumentowane dodatkowe choroby towarzyszące, a liczba dzieci z dostępem do neurologów była niewystarczająca. Badanie wskazuje na potrzebę lepszego rejestrowania przypadków epilepsji i lepszej koordynacji opieki medycznej, szczególnie w obszarach bez wyspecjalizowanej obsługi neurologicznej.
Oryginalny abstract (angielski)
Abstract Objective: Contemporary state-level data on pediatric epilepsy ascertainment and comorbidity documentation are limited. We described program-ascertained epilepsy rates and documented comorbidities among children and youth with epilepsy identified through Michigan’s Children’s Special Health Care Services (CSHCS) program. Methods: We conducted a retrospective open-cohort analysis of administrative records from CSHCS program for beneficiaries aged 0–20 years during 2016–2022. Epilepsy was identified using ICD-10-CM G40 codes in enrollment or annual medical review records. Annual program-ascertained epilepsy rates used CSHCS-identified cases as the numerator and age-specific Michigan population counts as the denominator. Comorbidities were categorized from ICD-10-CM codes using an ever-documented approach. Multilevel logistic regression examined factors associated with any documented comorbidity, accounting for county clustering. Results: CSHCS identified 8,499 unique beneficiaries with epilepsy. In 2022, the program-ascertained rate was 152 per 100,000 residents aged 0–20 years, below published population estimates. At least one comorbidity was documented for 2,503 beneficiaries, 29.4%. Documented comorbidity was associated with younger age, citizenship, seizure documentation category, race/ethnicity, and region. Nearly half resided in counties with no neurologists recorded in the Area Health Resource File. Conclusions: CSHCS data identify an important subset of Michigan children and youth with epilepsy. Findings support linked datasets, standardized documentation, and registry-based surveillance to improve ascertainment, care coordination, and resource planning.