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Calculating total health service utilisation and costs from routinely collected electronic health records using the example of patients with irritable bowel syndrome before and after their first gastroenterology appointment

Canavan, Caroline; West, Joe; Card, Timothy R.

Authors

Caroline Canavan

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology

Dr TIM CARD tim.card@nottingham.ac.uk
Clinical Associate Professor



Abstract

INTRODUCTION: Health economic models are increasingly important in funding decisions but most are based on data, which may therefore not represent the general population. We sought to establish the potential of real-world data available within the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) to determine comprehensive healthcare utilisation and costs as input variables for economic modelling.
METHODS: A cohort of patients with irritable bowel syndrome (IBS) who first saw a gastroenterologist in 2008 or 2009, and with 3 years of data before and after their appointment, was created in the CPRD. Primary care, outpatient, inpatient, prescription and colonoscopy data were extracted from the linked CPRD and HES. The appropriate cost to the NHS was attached to each event. Total and stratified annual healthcare utilisation rates and costs were calculated before and after the gastroenterology appointment with distribution parameters. Absolute differences were calculated with 95 % confidence intervals.
RESULTS: Total annual healthcare costs over 3 years increase by £935 (95 % CI £928–941) following a gastroenterology appointment for IBS. We derived utilisation and cost data with parameter distributions stratified by demographics and time. Women, older patients, smokers and patients with greater comorbidity utilised more healthcare resources, which generated higher costs.
CONCLUSIONS: These linked datasets provide comprehensive primary and secondary care data for large numbers of patients, which allows stratification of outcomes. It is possible to derive input parameters appropriate for economic models and their distributions directly from the population of interest.

Citation

Canavan, C., West, J., & Card, T. R. (in press). Calculating total health service utilisation and costs from routinely collected electronic health records using the example of patients with irritable bowel syndrome before and after their first gastroenterology appointment. PharmacoEconomics, 34(2), https://doi.org/10.1007/s40273-015-0339-y

Journal Article Type Article
Acceptance Date Oct 1, 2015
Online Publication Date Oct 25, 2015
Deposit Date Sep 1, 2016
Publicly Available Date Mar 28, 2024
Journal PharmacoEconomics
Print ISSN 1170-7690
Electronic ISSN 1170-7690
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 34
Issue 2
DOI https://doi.org/10.1007/s40273-015-0339-y
Public URL https://nottingham-repository.worktribe.com/output/763220
Publisher URL http://link.springer.com/article/10.1007%2Fs40273-015-0339-y
Related Public URLs http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4760998/

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