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

Abstract

IntroductionHealth 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.MethodsA 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.ResultsTotal 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.ConclusionsThese 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.

Methods for estimating costs in patients with hyperlipidemia experiencing their first cardiovascular event in the United Kingdom

“…Furthermore, HES Outpatient data are now available, which may provide more detail. For studies using HES Outpatient data, the process of costing visits is provided by Canavan et al 7 .…”

“…As a result of these resources, a variety of studies have been conducted that estimate costs based on resource utilization derived from CPRD and HES data, many of which were published recently [7][8][9][10][11][12][13][14][15][16][17][18] . However, it is still challenging to understand the methods used, and to implement them in research 19 .…”

Effects of treatment with eluxadoline on abdominal pain in patients with IBS‐D: Additional post hoc analyses of Phase 3 trials

“…IBS affects an estimated 11% of the global population, with the diarrhea‐predominant subtype (IBS‐D) accounting for approximately one‐third of cases . Symptoms of IBS‐D include diarrhea, abdominal pain, urgency, and bloating; these can vary greatly in severity and can have a considerable impact on patients’ quality of life …”

Sham acupuncture is as efficacious as true acupuncture for the treatment of IBS: A randomized placebo controlled trial

“…The irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain and altered bowel habit, affects up to 10% of the Western adult population and exacts a significant societal cost . It causes significant morbidity for patients, being among the commonest causes for individual absenteeism from work and school, and the management of this disorders cost billions of dollars annually for diagnostic tests alone . Estimates of healthcare costs in England for an IBS patient over 3 years following their first appointment to a gastroenterologist suggest they increase by £935 compared to the 3 years prior .…”