A comparative cost analysis of functional neurological disorder with other neurological disorders in patients admitted at Universitas Academic Hospital Neurology Ward

Abstract

Background: There is a lack of published data about functional neurological disorder and related costs incurred on the health care system in South Africa. Aim: To compare the health care costs of functional neurological disorder (FND) to those of other neurological conditions admitted in an inpatient setting. Setting: Universitas Tertiary Academic Hospital, Neurology Department, Free State, South Africa. Method: Secondary data was collected from Meditech for the period of 1 January 2018 until 31 December 2019. All neurology patient records were reviewed to ensure that patients with FND admitted during the study period were correctly identified. A descriptive data analysis was performed with means and standard deviations calculated for all patients included in the analysis. Categorical variables were summarised by frequencies and percentages. P-values were reported as a measure of significance for the main outcome variable, namely cost. Results: A total of 530 patients were admitted during the study period. Every 12th patient with a diagnosis other than FND were chosen as the comparator group. Of the 58 patients included in the study, 29/58 (50%) had a diagnosis of FND and 29/58 (50%) were admitted for other neurological disorders. A median age of 28 years IQR (19-36) was reported for the patients diagnosed with FND and 34 years IQR (25-45) for admissions with comparable neurological diagnoses. Both groups had similar gender representations with 11/29 (37.9%) being male, and 18/29 (62.1%) females. The median length of stay was significantly shorter (p value 0.007) for patients diagnosed with FND. Patients with FND most commonly (41.4%) presented with paraplegia. The average cost for the FND patients was significantly less (p value 0.008) than other neurological disorders. The majority (72.4%) of patients admitted for FND was from a low-income category. Conclusion: Patients admitted at the neurology ward with FND incurred lower costs and had fewer medical comorbidities than patients diagnosed with other neurological disorders.