Diseases of the skin and subcutaneous tissue refers to a broad spectrum of diseases including those of the skin, hair, nails, related muscles and glands. The majority of the UK population currently suffer or have suffered from skin disease at some point in their lifetime. The management of skin conditions is associated with significant healthcare costs especially when including the psychological impact many patients report as a result of a skin condition.
The aim of this study is to describe, over time, the number of people who have diseases of the skin and subcutaneous tissue in the UK and estimate the healthcare costs associated with managing these conditions. How often a disease occurs in our population plays an important role in planning NHS services and identifying areas for future research and development.
Research-quality patients with a disease of the skin and subcutaneous tissue will be selected. 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 over the same period. 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.
Our aim is to determine the epidemiology of diseases involving the skin and subcutaneous tissue and estimate and cost 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 disease of the skin and subcutaneous tissue. For sensitivity analyses, a subcohort will comprise English patients eligible for linkage to the Hospital Episode Statistics (HES) admitted patient care (APC) and outpatient datasets, and their Office for National Statistics (ONS) death registration data. 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; 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. Presentation date will be defined as the patient’s first ever record with a code indicative of the skin and subcutaneous tissue. Incident patients will be selected where 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 and comprise primary care contacts, primary care prescriptions, outpatient attendances and hospital admissions. 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 and general practice where appropriate at the date of the case’s start of follow-up. Quintiles of deprivation score will be described. Incidence and point prevalence will be calculated on a yearly basis.
This study will provide information on the healthcare burden associated with diseases of the skin and subcutaneous tissue and help to inform healthcare decision-making.
Patient characteristics; Comorbidities; Healthcare resource use; Healthcare costs; All-cause 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
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
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