Infectious diseases can be passed from person to person and include viral hepatitis (inflammation of the liver), human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS, a virus that attacks the immune system), measles, polio (a virus that attacks the nervous system), sexually transmitted infections, tuberculosis (TB, a bacteria that affects the lungs), vector-borne diseases (transmitted between humans or from animals to humans, often via a blood-sucking insect) and parasitic diseases (caused by an organism living on or inside the body). In the infectious disease’s strategy 2020-2025, Public Health England (PHE) has committed to tackling the increase in sexually transmitted infections, eradicating HIV transmission and supporting World Health Organization (WHO) elimination targets for TB and hepatitis B and C.
Our aim is to describe the number of people who have an infectious or parasitic disease 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 highlighting areas for future research and development.
Research-quality patients with an infectious or parasitic disease will be selected. The number of people developing the disease (its incidence) will be calculated yearly for the duration of the data source, and the proportion of people having that disease 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 descriptive epidemiology of infectious and parasitic diseases and estimate and cost healthcare use by people with these diseases. Acceptable patients will be selected from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets if they have a medical code indicative of an infectious or parasitic disease. 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. 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 with a code indicative of the infectious or parasitic disease. For incident patients, selected if their presentation date occurs at least 90 days after registration, detailed patient characteristics will be determined. 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 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 infectious and parasitic diseases 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