Costs of adult functional neurological disorders at a tertiary hospital in central South Africa

Background: Functional neurological disorders (FND) lead to increased care requirements and costs, negatively impacting healthcare budgets. Healthcare expenditure in FND has escalated beyond other neurologic disorders during the past decade. Objectives: To assess inpatient costs in adults admitted...

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Main Authors: Leonriche L.C. Christopher, Paul J. Pretorius, Anand Moodley, Gina Joubert, Tracy Arendse
Format: Article
Language:English
Published: AOSIS 2023-06-01
Series:South African Journal of Psychiatry
Subjects:
Online Access:https://sajp.org.za/index.php/sajp/article/view/2010
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author Leonriche L.C. Christopher
Paul J. Pretorius
Anand Moodley
Gina Joubert
Tracy Arendse
author_facet Leonriche L.C. Christopher
Paul J. Pretorius
Anand Moodley
Gina Joubert
Tracy Arendse
author_sort Leonriche L.C. Christopher
collection DOAJ
description Background: Functional neurological disorders (FND) lead to increased care requirements and costs, negatively impacting healthcare budgets. Healthcare expenditure in FND has escalated beyond other neurologic disorders during the past decade. Objectives: To assess inpatient costs in adults admitted to the neurology ward at Universitas Academic Hospital (UAH) in central South Africa. Methods: A retrospective observational study with a comparative component was conducted on patients admitted during 2018 and 2019. All FND cases (n = 29) and a systematic sample of other neurological disorders were included in the comparison group (n = 29). Data were obtained from the Meditech billing system and clinical records. Results: FND patients accounted for 5.5% of 530 admissions in the neurology ward during the study period. No significant differences regarding daily median cost, age categories, gender or medical comorbidity were observed between FND and the comparison group. However, the length of stay was significantly shorter for the FND patients (median of four versus eight days), translating to approximately half the total costs of patients admitted for other neurological disorders. Conclusion: The daily median cost was similar for FND and other neurology-related admissions. The lower overall inpatient costs for FND patients were only related to significantly shorter durations of stay, which may reflect new diagnostic approaches resulting from changes in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria. The prevalence of FND was similar to those reported in previous studies conducted at neurology clinics. Contribution: The study contributes towards better understanding the prevalence and cost of FND in local neurology inpatient care settings.
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spelling doaj.art-e1ff81f2f81247c18bc6c072310e37032023-07-03T12:34:43ZengAOSISSouth African Journal of Psychiatry1608-96852078-67862023-06-01290e1e610.4102/sajpsychiatry.v29i0.2010654Costs of adult functional neurological disorders at a tertiary hospital in central South AfricaLeonriche L.C. Christopher0Paul J. Pretorius1Anand Moodley2Gina Joubert3Tracy Arendse4Department of Psychiatry, Faculty of Health Sciences, University of the Free State, BloemfonteinDepartment of Psychiatry, Faculty of Health Sciences, University of the Free State, BloemfonteinDepartment of Neurology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; and Department of Neurology, School of Clinical Medicine, University of KwaZulu-Natal, DurbanDepartment of Biostatistics, Faculty of Health Sciences, University of the Free State, BloemfonteinDivision of Public Health Surveillance and Response National Institute for Communicable Diseases, JohannesburgBackground: Functional neurological disorders (FND) lead to increased care requirements and costs, negatively impacting healthcare budgets. Healthcare expenditure in FND has escalated beyond other neurologic disorders during the past decade. Objectives: To assess inpatient costs in adults admitted to the neurology ward at Universitas Academic Hospital (UAH) in central South Africa. Methods: A retrospective observational study with a comparative component was conducted on patients admitted during 2018 and 2019. All FND cases (n = 29) and a systematic sample of other neurological disorders were included in the comparison group (n = 29). Data were obtained from the Meditech billing system and clinical records. Results: FND patients accounted for 5.5% of 530 admissions in the neurology ward during the study period. No significant differences regarding daily median cost, age categories, gender or medical comorbidity were observed between FND and the comparison group. However, the length of stay was significantly shorter for the FND patients (median of four versus eight days), translating to approximately half the total costs of patients admitted for other neurological disorders. Conclusion: The daily median cost was similar for FND and other neurology-related admissions. The lower overall inpatient costs for FND patients were only related to significantly shorter durations of stay, which may reflect new diagnostic approaches resulting from changes in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria. The prevalence of FND was similar to those reported in previous studies conducted at neurology clinics. Contribution: The study contributes towards better understanding the prevalence and cost of FND in local neurology inpatient care settings.https://sajp.org.za/index.php/sajp/article/view/2010functional neurological disorderneurological disordersinpatient costshospitalisationfnd prevalencefnd demographic variables.
spellingShingle Leonriche L.C. Christopher
Paul J. Pretorius
Anand Moodley
Gina Joubert
Tracy Arendse
Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
South African Journal of Psychiatry
functional neurological disorder
neurological disorders
inpatient costs
hospitalisation
fnd prevalence
fnd demographic variables.
title Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
title_full Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
title_fullStr Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
title_full_unstemmed Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
title_short Costs of adult functional neurological disorders at a tertiary hospital in central South Africa
title_sort costs of adult functional neurological disorders at a tertiary hospital in central south africa
topic functional neurological disorder
neurological disorders
inpatient costs
hospitalisation
fnd prevalence
fnd demographic variables.
url https://sajp.org.za/index.php/sajp/article/view/2010
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