Dataset Information

Resource use and direct medical costs of acute respiratory illness in the UK based on linked primary and secondary care records from 2001 to 2009.

ABSTRACT: BACKGROUND:Previous studies have shown that influenza is associated with a substantial healthcare burden in the United Kingdom (UK), but more studies are needed to evaluate the resource use and direct medical costs of influenza in primary care and secondary care. METHODS:A retrospective observational database study in the UK to describe the primary care and directly-associated secondary care resource use, and direct medical costs of acute respiratory illness (ARI), according to age, and risk status (NCT Number: 01521416). Patients with influenza, ARI or influenza-related respiratory infections during 9 consecutive pre-pandemic influenza peak seasons were identified by READ codes in the linked Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES) dataset. The study period was from 21st January 2001 to 31st March 2009. RESULTS:A total of 156,193 patients had ?1 general practitioner (GP) episode of ARI, and a total of 82,204 patients received ?1 GP prescription, at a mean of 2.5 (standard deviation [SD]: 3.0) prescriptions per patient. The total cost of GP consultations and prescriptions equated to £462,827 per year per 100,000 patients. The yearly cost of prescribed medication for ARI was £319,732, at an estimated cost of £11,596,350 per year extrapolated to the UK, with 40% attributable to antibiotics. The mean cost of hospital admissions equated to a yearly cost of £981,808 per 100,000 patients. The total mean direct medical cost of ARI over 9 influenza seasons was £21,343,445 (SD: £10,441,364), at £136.65 (SD: £66.85) per case. CONCLUSIONS:Extrapolating to the UK population, for pre-pandemic influenza seasons from 2001 to 2009, the direct medical cost of ARI equated to £86 million each year. More studies are needed to assess the costs of influenza disease to help guide public health decision-making for seasonal influenza in the UK.

SUBMITTER: Meier GC

PROVIDER: S-EPMC7410242 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Resource use and direct medical costs of acute respiratory illness in the UK based on linked primary and secondary care records from 2001 to 2009.

Meier Geneviève C GC Watkins John J McEwan Phil P Pockett Rhys D RD

PloS one 20200806 8

<h4>Background</h4>Previous studies have shown that influenza is associated with a substantial healthcare burden in the United Kingdom (UK), but more studies are needed to evaluate the resource use and direct medical costs of influenza in primary care and secondary care.<h4>Methods</h4>A retrospective observational database study in the UK to describe the primary care and directly-associated secondary care resource use, and direct medical costs of acute respiratory illness (ARI), according to ag ...[more]

PMID: 32760071

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Project description:BackgroundInternet-based surveillance systems to monitor influenza-like illness (ILI) have advantages over traditional (physician-based) reporting systems, as they can potentially monitor a wider range of cases (i.e. including those that do not seek care). However, the requirement for participants to have internet access and to actively participate calls into question the representativeness of the data. Such systems have been in place in a number of European countries over the last few years, and in July 2009 this was extended to the UK. Here we present results of this survey with the aim of assessing the reliability of the data, and to evaluate methods to correct for possible biases.MethodsInternet-based monitoring of ILI was launched near the peak of the first wave of the UK H1N1v influenza pandemic. We compared the recorded ILI incidence with physician-recorded incidence and an estimate of the true number of cases over the course of the epidemic. We also compared overall attack rates. The effect of using different ILI definitions and alternative denominator assumptions on incidence estimates was explored.ResultsThe crude incidence measured by the internet-based system appears to be influenced by individuals who participated only once in the survey and who appeared more likely to be ill. This distorted the overall incidence trend. Concentrating on individuals who reported more than once results in a time series of ILI incidence that matches the trend of case estimates reasonably closely, with a correlation of 0.713 (P-value: 0.0001, 95% CI: 0.435, 0.867). Indeed, the internet-based system appears to give a better estimate of the relative height of the two waves of the UK pandemic than the physician-recorded incidence. The overall attack rate is, however, higher than other estimates, at about 16% when compared with a model-based estimate of 6%.ConclusionInternet-based monitoring of ILI can capture the trends in case numbers if appropriate weighting is used to correct for differential response. The overall level of incidence is, however, difficult to measure. Internet-based systems may be a useful adjunct to existing ILI surveillance systems as they capture cases that do not necessarily contact health care. However, further research is required before they can be used to accurately assess the absolute level of incidence in the community.

Project description:A Skinner mercury vapor light trap was operated from 2001 through 2009 in a residential backyard to document biodiversity within the moth families Thyatiridae, Drepanidae, Geometridae, Mimallonidae, Apatelodidae, Lasiocampidae, Saturniidae, Sphingidae, Erebidae (including Lymantriinae and Arctiinae), Euteliidae, Nolidae, and Noctuidae. When making comparisons to older literature, we recalculated our results to conform to the older classification of the Noctuoidea. Moths were released after identification. There were 501 species documented in 77581 captures from 1290 sampling dates. There was a perceived risk that released moths would fly back into the trap the following evening. This should result in an abnormal number of rare moths that are caught multiple times. The number of species caught twice versus the number caught once was no different than a similar ratio for surveys that used more traditional sampling methods. Therefore this concern does not seem to be valid for these data. These data are provided in a supplementary file available for download. There were three previous surveys conducted in nearby natural areas. They documented fewer species than were documented here. To understand this better, we examined several specialized groups of moths that tend to use host plants not typically found in an urban residential yard. More species in Schinia Hübner, Catocala Schrank, Acronicta Ochsenheimer, and Herminiinae Leech were found in this survey than the other local surveys. Only in the Papaipema Smith did we recover fewer species, though it was still above 70% of what was expected. This diversity could be a result of sampling effort, but it shows that this urban location has a very diverse moth fauna. We suggest that this diversity is partly due to the planting of native plant species in the area about the light trap. Therefore we would concur with others that urban landscapes can be planned to increase biodiversity relevant to more natural ecosystems. In this study we looked at the ratio of the number of species of Geometridae divided by the number of species of Noctuidae as one approach to evaluating the level of disturbance in the moth assemblage. Although the yearly average was nearly constant, the seasonal ratio ranged from 0.09 to 0.91 depending on the sampling date. We also calculated alpha diversity and found that seasonal change in alpha diversity greatly exceeded yearly differences. This strong seasonal component means that a comparison between two studies requires a correction for seasonality and similar sampling intervals. In this study, a shift of two weeks would be sufficient to result in a significant difference in alpha diversity. This is the equivalent of increasing temperature by 1.53 °C. Seasonal shifts limit the usefulness of this methodology for environmental assessment because the within season change exceeds the between season change. This problem is compounded when sampling designs interact with this seasonality. In describing our data, we made use of a growing degree day (GDD) model. This approach corrects for simple temperature dependent shifts in moth biology. Consequently, some of the variability in the data was removed, which should improve the power of statistical tests involving survey data. If sampling protocols were based on growing degree days rather than calendar dates, the bias caused by temperature induced shifts in seasonal cycles could be reduced.

Project description:The conduct of clinical trials should be an integral part of routine patient care. Treating patients in trials incurs additional costs over and above standard of care (SOC), but the extent of the cost burden is not known. We undertook a retrospective cost attribution analysis to quantitate the treatment costs associated with cancer clinical trial protocols conducted over a 2 year period.All patients entered into oncology (non-haematology) clinical trials involving investigational medicinal products in 2009 and 2010 in a single UK institution were identified. The trial protocols on which they were treated were analysed to identify the treatment costs for the experimental arm(s) of the trial and the equivalent SOC had the patient not been entered in the trial. The treatment cost difference was calculated by subtracting the experimental treatment cost from SOC cost. For randomised trials, an average treatment cost was estimated by taking into account the number of arms and randomisation ratio. An estimate of the annual treatment costs was calculated.A total of 357 adult oncology patients were treated on 53 different trial protocols: 40 phase III, 2 randomised II/III and 11 phase II design. A total of 27 trials were academic, non-commercial sponsored trials and 26 were commercial sponsored trials. When compared with SOC, the average treatment cost per patient was an excess of £431 for a non-commercial trial (range £6393 excess to £6005 saving) and a saving of £9294 for a commercial trial (range £0 to £71,480). There was an overall treatment cost saving of £388,719 in 2009 and £496,556 in 2010, largely attributable to pharmaceutical company provision of free drug supplies.On an average, non-commercial trial protocols were associated with a small per patient excess treatment cost, whereas commercial trials were associated with a substantially higher cost saving. Taking into account the total number of patients recruited annually, treatment of patients on clinical trial protocols was associated with considerable cost savings across both the non-commercial and commercial portfolio.

Project description:AimTo estimate annual societal costs associated with chemotherapy for early breast cancer in the UK.DesignMixed methods: (a) an incidence-based cost-of-illness model was developed of indirect costs in patients with breast cancer and carers, and estimated from diagnosis through active treatment until death; (b) interviews with stakeholders were also undertaken to understand actual experiences and impacts of these costs.Data sourcesModel data were collated from relevant national data sources covering general population statistics, UK cancer registries, clinical guidelines and published literature, and patient survey data. Patient and staff views were collected through semistructured interviews.ParticipantsModel: patients with early breast cancer receiving systemic anticancer therapy in the UK. Interviews were undertaken with women who had chemotherapy and medical practitioners involved in breast cancer care.ResultsTotal costs of chemotherapy in the UK economy are over £248 million. Societal productivity losses amount to £141.4 million, which includes £3.2 million associated with premature mortality, short-term and long-term work absence (£28.6 million and £105 million, respectively). £3.4 million is associated with mortality losses from secondary malignancies due to adjuvant chemotherapy. A further £1.1 million in lost productivity arises from informal care provision. Out-of-pocket costs per round of chemotherapy account for £4.2 million, or an annual average of almost £1100 per patient. Interview findings support the cost burden modelled and also highlight the impact on cognitive function of patients and how this could increase the cost burden to patients, their families and wider society. In addition, estimated costs for carer emotional well-being are £82 million in lost quality of life.ConclusionChemotherapy use carries significant indirect costs for society, as well as patients and their carers. These wider costs and societal perspective should be considered by commissioners to ensure chemotherapy is better targeted at those who most need it and to avoid placing unnecessary costs on patients, their caregivers and wider society.

Dataset Information

Resource use and direct medical costs of acute respiratory illness in the UK based on linked primary and secondary care records from 2001 to 2009.

Publications

Resource use and direct medical costs of acute respiratory illness in the UK based on linked primary and secondary care records from 2001 to 2009.

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