| アブストラクト | 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 pound2173 over 1 year including surgery. Total costs per person-quarter were pound1983 in the quarter containing surgery, mostly comprising surgical inpatient care costs ( pound1902), and around pound60 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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| 投稿者 | Clarke, Caroline S; Williamson, Elizabeth; Denaxas, Spiros; Carpenter, James R; Thomas, Mike; Blackshaw, Helen; Schilder, Anne G M; Philpott, Carl M; Hopkins, Claire; Morris, Stephen |
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| 組織名 | Research Department of Primary Care and Population Health, University College;London, London, UK caroline.clarke@ucl.ac.uk.;Department of Medical Statistics, London School of Hygiene & Tropical Medicine,;London, UK.;Health Data Research UK, London, UK.;Institute of Health Informatics, University College London, London, UK.;MRC Clinical Trials Unit at UCL, University College London, London, UK.;Primary Care and Population Science, University of Southampton, Southampton, UK.;ENT Clinical, Zeist, The Netherlands.;NIHR UCLH Biomedical Research Centre, London, UK.;Ear Institute, University College London, London, UK.;Norwich Medical School, University of East Anglia, Norwich, UK.;ENT Department, James Paget University Hospitals NHS Foundation Trust, Great;Yarmouth, UK.;ENT Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.;Primary Care Unit, Department of Public Health and Primary Care, University of;Cambridge, Cambridge, UK. |
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