A New Model of Health Care Leads to Lower Cost and Better Quality of Care

With the staggering number of patients with epilepsy utilizing emergency department care,William Tatum, M.D.,Clinical Associate Professor at the University of South Florida, and Thomas L. Orth, Executive Director, Epilepsy Services of West Central Florida are exploring another alternative- case management. “Case management, according to the results of our pilot study, is a cost effective way of improving the quality of services rendered for patients with epilepsy,” said Dr. Tatum, today at the 58th annual AES conference in New Orleans.

In a pilot study conducted by Tatum and Orth, 737 patients were enrolled in a case management program provided by a single not-for-profit, state supported epilepsy service provider for a 4-county area in west central Florida. Initial and follow-up survey forms from 159 new consecutive patients were compared before and after case management from the beginning of 2002 through 2003. Surveys were supplied by the Florida Department of Health and administered to patients upon admission. Follow-up survey information was obtained as well, along with medical record review.

“Prior to case management most of our patients were unemployed, uninsured and relying on Emergency Department services for health care. In this pilot study there have been robust results indicating significant benefits in terms of seizure control, quality of life and employment in those patients that underwent case management. Also there has been a 90% reduction in the number of individuals visiting the Emergency Department for medical care,” said Tatum. Tatum believes a case management paradigm is a “win-win” situation for both patients and health care providers in that case management provides continuity of care for patients, greater compliance, less reliance on Emergency Department services and is an overall cost effective way to treat patients with a chronic health condition like epilepsy.

Currently, ongoing analysis of the data is being compiled. Tatum is hoping to use the results from the study to incite a larger scale application of case management.

The abstract of this study is published in Epilepsia 2004, Volume 45, Supplement 7, p.87.