Begley C.E., Baker G.A., Beghi E., Butler J., Chisholm D., Langfitt J.T., Levy P., Pachlatko C., Wiebe S., Donaldson K.L.
School of Public Health, University of Texas, United States; Division of Neurosciences, University of Liverpool, Liverpool, United Kingdom; Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy; Department of Neurology, University of Stellenbosch, Johannesburg, South Africa; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Department of Neurology, University of Rochester, School of Medicine, Rochester, United States; Universite Paris-Dauphine, Place Marechal de Lattre de Tassigny, Paris, France; Swiss Epilepsy Centre, Switzerland; Division of Neurology, Foothills Medical Centre, Calgary, Alta., Canada; Epilepsy Action, Leeds, United Kingdom; School of Public Health, University of Texas, Health Science Center, 1200 Herman Pressler, Houston, TX 77030, United States
Begley, C.E., School of Public Health, University of Texas, United States, School of Public Health, University of Texas, Health Science Center, 1200 Herman Pressler, Houston, TX 77030, United States; Baker, G.A., Division of Neurosciences, University of Liverpool, Liverpool, United Kingdom; Beghi, E., Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy; Butler, J., Department of Neurology, University of Stellenbosch, Johannesburg, South Africa; Chisholm, D., Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Langfitt, J.T., Department of Neurology, University of Rochester, School of Medicine, Rochester, United States; Levy, P., Universite Paris-Dauphine, Place Marechal de Lattre de Tassigny, Paris, France; Pachlatko, C., Swiss Epilepsy Centre, Switzerland; Wiebe, S., Division of Neurology, Foothills Medical Centre, Calgary, Alta., Canada; Donaldson, K.L., Epilepsy Action, Leeds, United Kingdom
Purpose: The International League Against Epilepsy (ILAE) Commission on Healthcare Policy in consultation with the World Health Organization (WHO) examined the applicability and usefulness of various measures for monitoring epilepsy healthcare services and systems across countries. The goal is to provide planners and policymakers with tools to analyze the impact of healthcare services and systems and evaluate efforts to improve performance. Methods: Commission members conducted a systematic literature review and consulted with experts to assess the nature, strengths, and limitations of the treatment gap and resource availability measures that are currently used to assess the adequacy of epilepsy care. We also conducted a pilot study to determine the feasibility and applicability of using new measures to assess epilepsy care developed by the WHO including Disability-Adjusted Life Years (DALYs), responsiveness, and financial fairness. Results: The existing measures that are frequently used to assess the adequacy of epilepsy care focus on structural or process factors whose relationship to outcomes are indirect and may vary across regions. The WHO measures are conceptually superior because of their breadth and connection to articulated and agreed upon outcomes for health systems. However, the WHO measures require data that are not readily available in developing countries and most developed countries as well. Conclusion: The epilepsy field should consider adopting the WHO measures in country assessments of epilepsy burden and healthcare performance whenever data permit. Efforts should be made to develop the data elements to estimate the measures. © 2007 International League Against Epilepsy.