Columbus, OH — January 2018
A number of studies have shown that vagus nerve stimulation therapy is effective for young patients with epilepsy, but most research demonstrating the therapy actually keeps patients out of the hospital has only considered adults.
A new publication from physician-researchers at Nationwide Children’s Hospital – using data from the country’s largest pediatric accountable care organization, Partners For Kids – reports that after vagus nerve stimulation implantation, a group of children were much less likely to have unplanned hospitalizations than before.
The study was published in the Journal of Child Neurology.
“This claims data allows us to capture all health care visits, unlike electronic health records, which may lead us to miss visits outside of our institution or network,” says Satya Gedela, MD, member of the Division of Neurology at Nationwide Children’s, medical director of the hospital’s Epilepsy Surgery Program and the study’s senior author. “It’s a small cohort, but our results show us that beyond a potential reduction in seizures, the therapy allows patients and their families to use the hospital less frequently.”
The authors examined the claims data of 13 patients over a 6-to-12 month window before vagus nerve stimulator implantation and a separate 6-12 month window after. The patients were an average of 10.5 years of age at implantation, though the youngest was 4 years old.
The total number of unplanned hospitalizations dropped from 16 in the pre-implantation period to 4 in the post-implantation period, or from 0.13 per month to .02 to per month. Emergency department and clinic visits were essentially unchanged per month. The stable clinic numbers were a surprise, the authors say, because implantation usually necessitates additional visits to make dosing changes.
Partners For Kids, the accountable care organization, is a partnership between Nationwide Children’s and area physicians and is responsible for approximately 330,000 children covered by Medicaid in central and southeastern Ohio. Its focus on value-based care makes studies like this one important, and its claim data make these studies possible, says Dr. Gedela.
“Value-based care is increasingly important, and other studies are needed to show that seemingly costly treatments can help save money for families and for the health care system over time,” he says.
Patel A, Wang L, Gedela S. Health care utilization following vagus nerve stimulation therapy in pediatric epilepsy patients from a pediatric accountable care organization. Journal of Child Neurology. 2017 Nov 30. [Epub ahead of print]