Chronic Diseases (non-communicable diseases) cause a huge burden not only to individual patients but financially to the health service. This work using CPRD will inform a larger project (the FRESHER project) by allowing us to investigate the costs associated with having certain common chronic diseases in an English population and comparing them with a population of individuals who do not have common chronic diseases.
CPRD records which match our inclusion criteria will be linked to Hospital Episode Statistics (HES) and groups of patients which have chronic diseases will be compared to those without these diseases in primary and secondary care. Linked data will allow us to quantify healthcare utilisation for chronic disease over multiple care settings. For patients with only one chronic disease, excess costs are computed by subtracting the average cost of care for patients without chronic diseases from the average cost of care for patients with identified chronic diseases. For patients with multiple chronic diseases, the cost of care for patients with any chronic disease is subtracted from the cost of care for patients with more than one chronic disease.
This work aims to determine the cost-of-illness (COI) - the excess cost of healthcare utilisation - for 10 Non-Communicable Diseases (NCD's): Stroke, Heart disease, Cancer, Diabetes, Chronic kidney disease (CKD), Chronic obstructive pulmonary disease (COPD), Cirrhosis, Alcohol use disorder (AUD), Depression, and Neurological disorders (Alzheimer's and dementia).
The study population will be all acceptable patients in the November 2017 denominator file who are 18 and over in 2015 with a current registration date before study start and any length enrolment during the study period of 01/01/2015 - 31/12/2015 for practices with a UTS and LCD pre-post 2015. We will identify individuals with NCD's of interest, and compute the average healthcare costs associated with the healthcare utilisation of individuals with each specific NCD for any length within the study period using reference costs from the NHS. We will compare the average healthcare utilisation of patients with NCD's, stratified by age and sex, to those without NCD's.
This work replicates the methodology used to estimate NCD COI in France, Estonia and The Netherlands as part of the FRESHER project. Results from England will be used along with results from other countries to inform the FRESHER microsimulation model used to compare NCD costs across European countries.
Primary: Quantify differences in healthcare utilisation for people with 10 specific non-communicable diseases (NCDs) - stroke, heart disease, cancer, diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cirrhosis, alcohol use disorder (AUD), depression and neurologic disorders - relative to persons without these NCDs over the period of one year between 01/01/2015 and 01/01/2016.
- Secondary: Compute the additional cost of any excess healthcare utilisation over this period.
Franco Sassi - Chief Investigator - Imperial College London
Franco Sassi - Corresponding Applicant - Imperial College London
Jennifer Quint - Collaborator - Imperial College London
Sophie Thiebaut - Collaborator - Imperial College London
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient