Burden of Epilepsy: The Ontario Health Survey

BACKGROUND: Few data exist on the frequency and burden of epilepsy in Canada and on the impact of self-reported epilepsy in the general population. We assess the frequency, general health, psychosocial function, and health care resource use among self-identified epileptic persons in the general population. METHOD: The 1990 Ontario Health Survey is an omnibus, extensive health survey of 61,239 subjects representing the Ontario population. Self-reported epileptic subjects are compared with three groups, i.e., those with > or = 1 other chronic illnesses, the general population, and those with no health problems. RESULTS: The point prevalence of self-reported epilepsy was 5.8 per 1,000 population, a figure similar to that of active epilepsy in other studies. Quality of life, family function and social support were worse in epileptic than in other chronically ill subjects. Similarly, the epilepsy population had more disability days and limitations in activities, and lower annual income than all other groups, including the chronically ill. Accidents were no more common among epileptic subjects than among controls. Epileptic persons were high users of health care resources, including hospitalization, emergency room, psychological/social work, nursing services and telephone contact with health professionals. Barriers to health care were experienced infrequently. Small area variations in health status and care are explored. CONCLUSIONS: The health profile of self-reported epileptic subjects is similar to that obtained in studies involving defined epilepsy patients. In the general population, self-identification as having epilepsy carries a significant burden of illness, reflected in poorer health, psychosocial function, and quality of life, and higher health care resource use.