Portal de Periódicos da CAPES

Reduction of emergency department visits using an urgent clinic for children with established epilepsy

2016; Lippincott Williams & Wilkins; Volume: 6; Issue: 6 Linguagem: Inglês

10.1212/cpj.0000000000000286

2163-0933

Anup D. Patel, Debbie Terry, Jayne Pacheco Moore, Jacy Sale, Eric G. Wood, Zachary M. Grinspan, Daniel M. Cohen,

Healthcare Policy and Management

Emergency department (ED) visits and hospitalizations account for a large portion of the cost of care in people with established epilepsy. In an attempt to decrease seizure-related ED visits, we created an urgent epilepsy clinic (UEC) for children with epilepsy. Our aim was to decrease ED visits for patients seen in the clinic by 30% and decrease unplanned hospitalizations by 10% 3 months following an appointment.Children at risk for an ED visit or unplanned hospitalization were referred and seen by a nurse practitioner and social worker. Factors influencing the need for the appointment and actions taken were recorded. Cost savings were also calculated.A total of 317 patients were seen in the UEC clinic from October 2013 to July 2015. Ninety-three percent of scheduled patients completed their appointment, compared to 84% in other neurology clinics. Eighty-three percent of patients were seen in the clinic within 5 days of the referral. Children were significantly less likely to come to the ED in the 3 months after an appointment compared to the 3 months before.An urgent clinic for children with established epilepsy was associated with a reduction in ED visits for seizures and improved adherence to outpatient clinic appointments for seizures. Further research is needed to evaluate the cost-effectiveness of UECs, and to compare health services and clinical outcomes to those of children without access to such services.