To identify demographic variables associated with unplanned HRU in PWE.

Epilepsy is a common, chronic disease with a recognized high HRU. There is increased urgency to document, assess barriers, and reduce racial and economic disparities in care. Sparse data exists on short index time HRU.

We performed a retrospective cohort analysis of PWE compared with patients without epilepsy seen at 18 outpatient neurology clinics within an academic health system between June 2018 and August 2022. Among PWE, we assessed associations between demographic variables and HRU data at specific time points between HRU events and index neurology clinic visits using a logit model. Demographic data was combined with Health Plan claims HRU data in 4 domains (Mortality all causes, Hospitalization all causes, Emergency Department (ED) treat and release all causes and Urgent care all causes) at 7, 30 and 90-days from an index neurology clinic visit.

The epilepsy cohort included 6485 unique patients (13159 encounters; 53.1% females, 10.1% black, median age 46.4 years). The epilepsy cohort showed significantly more hospitalizations, ED visits, and urgent care visits at all time-points compared to the general neurology cohort (N=53422) (p<0.05). Within the epilepsy cohort: Male gender and Black race correlated with increased ED visits at all time-points; 2) age 65 and older (N=1602) with increased 90-day Mortality and 30 and 90-day Hospitalizations and decreased 7 and 30-day ED visits; 3) Patients within the highest 25th quartile of the area deprivation index (ADI) (N=2958 patients; 16.3 % black) showed increased 30 and 90-day ED visits (p<0.05).

Specific demographics among PWE are associated with unplanned HRU within the 4 domains assessed for PWE with a short index time from neurology outpatient visits. The observed differences may guide development of targeted tools for timely care interventions.