Household-level health and economic spillover effects associated with adult epilepsy in the United States.

OBJECTIVE

Epilepsy is associated with substantial health-related and economic burden, and prior spillover research has largely focused on caregivers. Little is known about the impact of epilepsy on other adults living in the same household. This study examined household-level spillover effects associated with epilepsy on mental health, productivity, and health care utilization and expenditures among adults without epilepsy.

METHODS

This cross-sectional study used 2017-2023 Medical Expenditure Panel Survey data to analyze adults aged 18 years and older without epilepsy living in households with versus without an adult with epilepsy. Adults in epilepsy households were compared with those in no-epilepsy households across sociodemographic characteristics, work-related outcomes, health-related quality of life, emotional well-being, and health care utilization and expenditures. Person- and survey-weighted regression models were used to estimate adjusted associations, clustering at the household level.

RESULTS

Adults without epilepsy living in epilepsy households had significantly lower mental health-related quality of life (adjusted mean difference = -2.1 points), 55% higher odds of missing work to care for others, and 52% higher odds of reporting worse general health than adults without epilepsy living in no-epilepsy households. Unadjusted person-level income was lower by approximately $3400 and health care expenditures were higher by approximately $5500 among adults without epilepsy living in an epilepsy household, although adjusted differences were not statistically significant.

SIGNIFICANCE: Adults without epilepsy living with an adult with epilepsy experience meaningful mental, emotional, and productivity spillover effects. Findings from this study suggest that the effects of epilepsy extend beyond the diagnosed individual to other adults living in the same household, and support the need for clinical, supportive, and policy approaches that address household-level consequences of the condition.