Observational retrospective study calculating health service costs of patients receiving surgery for chronic rhinosinusitis in England, using linked patient-level primary and secondary care electronic data.
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Authors
Williamson, Elizabeth
Denaxas, Spiros
Carpenter, James R
Thomas, Mike
Blackshaw, Helen
Schilder, Anne GM
MACRO programme team
Publication Date
2022-02-08Journal Title
BMJ Open
ISSN
2044-6055
Publisher
BMJ
Volume
12
Issue
2
Language
eng
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Clarke, C. S., Williamson, E., Denaxas, S., Carpenter, J. R., Thomas, M., Blackshaw, H., Schilder, A. G., et al. (2022). Observational retrospective study calculating health service costs of patients receiving surgery for chronic rhinosinusitis in England, using linked patient-level primary and secondary care electronic data.. BMJ Open, 12 (2) https://doi.org/10.1136/bmjopen-2021-055603
Description
Funder: Wellcome Trust
Abstract
OBJECTIVES: Chronic rhinosinusitis (CRS) symptoms are experienced by an estimated 11% of UK adults, and symptoms have major impacts on quality of life. Data from UK and elsewhere suggest high economic burden of CRS, but detailed cost information and economic analyses regarding surgical pathway are lacking. This paper estimates healthcare costs for patients receiving surgery for CRS in England. DESIGN: Observational retrospective study examining cost of healthcare of patients receiving CRS surgery. SETTING: Linked electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics databases in England. PARTICIPANTS: A phenotyping algorithm using medical ontology terms identified 'definite' CRS cases who received CRS surgery. Patients were registered with a general practice in England. Data covered the period 1997-2016. A cohort of 13 462 patients had received surgery for CRS, with 9056 (67%) having confirmed nasal polyps. OUTCOME MEASURES: Information was extracted on numbers and types of primary care prescriptions and consultations, and inpatient and outpatient hospital investigations and procedures. Resource use was costed using published sources. RESULTS: Total National Health Service costs in CRS surgery patients were £2173 over 1 year including surgery. Total costs per person-quarter were £1983 in the quarter containing surgery, mostly comprising surgical inpatient care costs (£1902), and around £60 per person-quarter in the 2 years before and after surgery, of which half were outpatient costs. Outpatient and primary care costs were low compared with the peak in inpatient costs at surgery. The highest outpatient expenditure was on CT scans, peaking in the quarter preceding surgery. CONCLUSIONS: We present the first study of costs to the English healthcare system for patients receiving surgery for CRS. The total aggregate costs provide a further impetus for trials to evaluate the relative benefit of surgical intervention.
Keywords
Otolaryngology, Clinical Trials, Health Economics
Sponsorship
National Institute for Health Research (NIHR) (NF-SI-0617-10068, NIHR202382, NIHR-RP-011-045, RP-PG-0614-20011)
British Heart Foundation (AA/18/6/24223)
Identifiers
PMC8830221, 35135774
External DOI: https://doi.org/10.1136/bmjopen-2021-055603
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334939
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