Regional variation in prevalence and healthcare utilization due to epilepsy in Sweden

Acta Neurol Scand. 2014 Dec;130(6):354-9. doi: 10.1111/ane.12274. Epub 2014 Jul 18.


Objective: To estimate the regional differences in the prevalence of epilepsy and the associated costs due to inpatient and outpatient care and anti-epileptic drug (AED) utilization for the years 2005 and 2011 in Sweden.

Methods: Region-specific estimates of the prevalence of epilepsy were obtained using a method based on a linkage of the healthcare and pharmaceutical registries and the cause of death registry. Regional cost components were estimated using registry data by region on inpatient and outpatient care utilization, AED sales, and mortality. Per-patient utilization and monetary costs were calculated.

Results: Estimated prevalence of epilepsy varied substantially across the regions in 2011, from 0.76% in Jämtland to 1.08% in Gotland. The national prevalence was 0.88%. The average number of hospitalizations per patient and year decreased at the national level between 2005 and 2011. At the national level, the per-patient specialized care (outpatient) utilization also decreased between 2005 and 2011. However, at the regional level, the decrease was not uniform, and in some counties, the per-patient utilization increased during the period studied. The per-patient utilization of AEDs increased in all counties, except Kronoberg, between 2005 and 2011. Moreover, between-region differences in healthcare and AED utilization, and significant differences between regions and national averages were revealed. Similarly, regional per-patient costs were shown to deviate from the national average in 13 of 21 regions.

Conclusions: There is significant variation in the prevalence of epilepsy and the provision of health care for patients with epilepsy across the different regions of Sweden.

Keywords: anti-epileptic drug utilization; anti-epileptic drugs; epilepsy; regional epilepsy prevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care / economics
  • Cost of Illness*
  • Epilepsy / economics*
  • Epilepsy / epidemiology*
  • Female
  • Hospitalization / economics
  • Humans
  • Male
  • Prevalence
  • Registries
  • Sweden / epidemiology