Health Care Utilization in [FND]s; Impact of Explaining the Diagnosis of Functional Seizures on Health Care Costs 2023 Lagrand et al

[Andy]

Abstract

Background and Objective
The objectives of this study were to investigate health care utilization costs of patients with video-electroencephalography (VEEG)–confirmed functional seizures (FS), determine whether patients who received a satisfactory functional neurologic disorder (FND) diagnosis explanation had reduced health care utilization compared with those with a poor explanation; and to quantify the overall health care costs 2 years prediagnosis and postdiagnosis for those receiving a different explanation.

Methods
Patients with VEEG-confirmed pure FS (pFS) or mixed (functional seizure plus epileptic seizures) diagnosis between July 1, 2017, and July 1, 2019, were evaluated. Explanation of the diagnosis was determined “unsatisfactory” or “satisfactory” using self-developed criteria, and health care utilization data were collected using an itemized list. The subsequent costs 2 years post-FND diagnosis were compared with those 2 years before, and cost outcomes were compared between both groups.

Results
In patients who received a satisfactory explanation (n = 18), total health care costs were reduced from $169,803 to $117,133 USD (−31%). An increase in costs was found ($73,430 to $186,553 USD = +154%) in patients with pPNES after an unsatisfactory explanation (n = 7). On an individual level, 78% with a satisfactory explanation saw a reduction in total health care costs per year (mean $5,111 USD to $1,728 USD), and in 57%, an unsatisfactory explanation led to an increase (mean $4,425 to $20,524 USD). A similar effect was seen from explanation on patients with a dual diagnosis.

Discussion
The method of communicating an FND diagnosis has a significant impact on subsequent health care utilization. Those receiving satisfactory explanations demonstrated reduced health care utilization, whereas an unsatisfactory explanation resulted in additional expenses.

Paywall, https://cp.neurology.org/content/13/1/e200111

 

[rvallee]

If all you want is for your patients to stop coming to see you, you could just slap them in the face and call them names. That will also work. Unless they like that, of course, but I doubt it would be statistically significant in a random sample.

Of course the question is why is this a valuable objective? You could simply shut down all this nonsense and it would reduce healthcare costs to zero. Well, direct costs anyway, but no one is counting the indirect costs so whatever. OK, there would be no actual savings but who's counting anyway? Not those guys, that's for sure.

I am amazed at the very high level of quality of care that is based simply on whether it is "satisfactory". By this standard, why bother creating a civilization when we could all simply live in holes in the ground? You want edible food? Just pick stuff on the ground, you fancy eater.

And considering how often I see posts talking about having had the "best medical appointment" ever, simply because they weren't dismissed and gaslighted, even though it didn't even help at all, a level of "satisfactory" is just extremely low.

They are aiming at the ground and somehow still miss it. Then paint a target around wherever it landed and call it satisfactory. Some people would call an astrological explanation "satisfactory". Not many but some definitely would.

This is all like terrible gory performance art except the stunts aren't stunts, they're real people. Basically snuff. Uh, don't google that. Trust me it means very bad.

 

[bobbler]

Abstract

Background and Objective
The objectives of this study were to investigate health care utilization costs of patients with video-electroencephalography (VEEG)–confirmed functional seizures (FS), determine whether patients who received a satisfactory functional neurologic disorder (FND) diagnosis explanation had reduced health care utilization compared with those with a poor explanation; and to quantify the overall health care costs 2 years prediagnosis and postdiagnosis for those receiving a different explanation.

Methods
Patients with VEEG-confirmed pure FS (pFS) or mixed (functional seizure plus epileptic seizures) diagnosis between July 1, 2017, and July 1, 2019, were evaluated. Explanation of the diagnosis was determined “unsatisfactory” or “satisfactory” using self-developed criteria, and health care utilization data were collected using an itemized list. The subsequent costs 2 years post-FND diagnosis were compared with those 2 years before, and cost outcomes were compared between both groups.

Results
In patients who received a satisfactory explanation (n = 18), total health care costs were reduced from $169,803 to $117,133 USD (−31%). An increase in costs was found ($73,430 to $186,553 USD = +154%) in patients with pPNES after an unsatisfactory explanation (n = 7). On an individual level, 78% with a satisfactory explanation saw a reduction in total health care costs per year (mean $5,111 USD to $1,728 USD), and in 57%, an unsatisfactory explanation led to an increase (mean $4,425 to $20,524 USD). A similar effect was seen from explanation on patients with a dual diagnosis.

Discussion
The method of communicating an FND diagnosis has a significant impact on subsequent health care utilization. Those receiving satisfactory explanations demonstrated reduced health care utilization, whereas an unsatisfactory explanation resulted in additional expenses.

Paywall, https://cp.neurology.org/content/13/1/e200111

Not read properly but initial instinct:

This is a bit 'on the nose' isn't it [meaning almost too exactly right, precise]? Normally the point is more carefully concealed?

 

[bobbler]

Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp

Isn't it time that at least information regarding conflicts of interest had to be included in the abstract part - particularly where it will involve substantial costs for anyone to read the full-text if they aren't a subscriber?