International Classification of Diseases, Tenth Revision (ICD-10) codes are used worldwide for defining and recording diseases and health conditions. Diseases and health conditions are classified into one of 22 chapters that form the ICD-10 hierarchy. Chapter XXII Codes for special purposes include antibiotic resistance and new diseases, including severe acute respiratory syndrome (SARS), COVID-19 and vaping-related disorders. SARS and COVID are similar airborne viruses that have caused pandemics in the last two decades. Vaping is considered a healthier alternative to smoking traditional cigarettes. At a population level, poor infection control and the overuse of antibiotics has contributed to the development of antibiotic resistance. The management of these diseases and health related conditions is associated with significant healthcare costs.
We aim to describe, over time, the number of people who have a disease located in Chapter XXII in the UK and estimate their healthcare costs. How often a disease occurs in our population plays an important role in planning NHS services and highlighting areas for future research and development.
Patients with a disease listed in Chapter XXII will be selected from CPRD. The number of people developing the condition (its incidence) will then be calculated on a yearly basis for the duration of the data source, and the proportion of people having that condition at the midyear point (its point prevalence) will be calculated. Time to death and patients’ characteristics will be presented. The frequency and cost of primary care consultations, prescriptions, outpatient attendances and inpatient stays will also be determined.
We aim to determine the descriptive epidemiology of diseases listed in ICD-10 Chapter XXII Codes for special purposes and estimate and cost of healthcare use by people with these conditions. Acceptable patients will be selected from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets if they have a medical code indicative of a condition listed in Chapter XXII Codes for special purposes. For sensitivity analyses, a subcohort will comprise English patients eligible for linkage to the HES admitted patient care (APC) and outpatient datasets, and their Office for National Statistics (ONS) death registration data. The start of CPRD follow-up will be defined as the later of the patient’s registration date and, in CPRD GOLD, their practice’s up-to-standard date; the end of CPRD data follow-up will be defined as the earliest of the patient’s transfer-out date, date of death (if applicable), and the last data-collection date for their practice. The presentation date will be defined as that of the patient’s first ever record indicative of a condition listed in Chapter XXII. Incident patients will be selected if their presentation date occurs at least 90 days after registration. Time to death will be presented using Kaplan–Meier analysis. Healthcare resource use and associated costs will be estimated before and after presentation. Healthcare costs will be compared with a non-exposed control group of acceptable, HES eligible patients matched in a 1:1 ratio on age, sex, registration status at the date of the case’s start of follow-up and general practice where appropriate. Quintiles of deprivation score will be described. Incidence and point prevalence will be calculated on a yearly basis.
This study will provide valuable information on the healthcare burden associated with conditions described in Chapter XXII Codes for special purposes and help to inform healthcare decision-making.
Patient characteristics; Comorbidities; Healthcare resource use; Healthcare costs; All-cause mortality; Cause-specific mortality; Incidence; Prevalence
Craig Currie - Chief Investigator - Pharmatelligence Limited t/a Human Data Sciences
Sarah Holden - Corresponding Applicant - Pharmatelligence Limited t/a Human Data Sciences
Benjamin Heywood - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Bethan Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Chris Shepherd - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christian Bannister - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christopher Morgan - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Darren Summers - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Elgan Mathias - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Ellen Hubbuck - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
James Bateman - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Rhiannon Thomason - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Thomas Berni - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation