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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

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
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

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 â € 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.

clinical trials, health economics, otolaryngology
2044-6055
Clarke, Caroline S
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Williamson, Elizabeth
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Denaxas, Spiros
aca23502-018a-4a05-9a76-e82ffc206ad7
Carpenter, James R
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Thomas, Mike
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Blackshaw, Helen
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Schilder, Anne G M
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Philpott, Carl M
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Hopkins, Claire
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Morris, Stephen
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MACRO programme team
Clarke, Caroline S
da4ad89b-f804-446f-a08d-f93e97db7c47
Williamson, Elizabeth
c170cef3-4f0a-459c-9dd9-f8937410ab93
Denaxas, Spiros
aca23502-018a-4a05-9a76-e82ffc206ad7
Carpenter, James R
a03ed481-5fab-4a61-9c50-8b04b0eaa4b3
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Blackshaw, Helen
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Schilder, Anne G M
4efe172e-cbc9-4d1b-b089-f293f5c626ef
Philpott, Carl M
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Hopkins, Claire
8ed0a5e3-92a3-4988-9c2b-b0e51a8a044c
Morris, Stephen
0abf603b-3b19-43a9-be25-a0f1e76c574c

Clarke, Caroline S, Williamson, Elizabeth, Denaxas, Spiros, Carpenter, James R, Thomas, Mike and Blackshaw, Helen , MACRO programme team (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), [e055603]. (doi:10.1136/bmjopen-2021-055603).

Record type: Article

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 â € 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.

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Accepted/In Press date: 11 January 2022
Published date: 8 February 2022
Keywords: clinical trials, health economics, otolaryngology

Identifiers

Local EPrints ID: 456348
URI: http://eprints.soton.ac.uk/id/eprint/456348
ISSN: 2044-6055
PURE UUID: ac2d9b9b-8244-479a-a1ae-fa6265144726

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Date deposited: 27 Apr 2022 02:26
Last modified: 27 Apr 2022 11:44

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Contributors

Author: Caroline S Clarke
Author: Elizabeth Williamson
Author: Spiros Denaxas
Author: James R Carpenter
Author: Mike Thomas
Author: Helen Blackshaw
Author: Anne G M Schilder
Author: Carl M Philpott
Author: Claire Hopkins
Author: Stephen Morris
Corporate Author: MACRO programme team

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