Introduction Like many hospitals through out the UK the National IBD Standards (endorsed by the British Society of Gastroenterology) and the IBD (Global Rating Score) Quality Improvement Programme (endorsed by The Royal College of Physicians) have help highlighted areas of our inflammatory bowel disease (IBD) service that clearly need improving. In order to attract funding from our local primary care trust (PCT) to support the necessary service improvements, we set about establishing the total cost and demand made on our local hospital in managing these patients. We set about assessing 4 key areas; the endoscopy service, the radiology service, the hospital admissions and the outpatient service.
Objective of this study: To assess the demand on the outpatient services made by IBD patients.
Methods The Luton & Dunstable University Hospital has a database of 2680 local IBD patients. This is made up of 1425 patients with UC, 941 with Crohn’s, 118 with proctitis, 113 with IBD unspecified, 53 with radiation proctitis, 13 with diversion colitis, 10 with ileo-anal pouchitis and 7 with microscopic colitis. Using the database the hospital coding system was used to analyse the total number of outpatient appointments (OPAs) made between 2001 and 2011 for these patients, and to which specialties they were referred. Total costs were calculated using a range of prices for the different specialties, depending on whether they were new (£210-£265) or follow up clinic visits (£83-£136).
Results Over the course of 10 years the 2680 IBD patients made 20,837 gastroenterology OPAs (2,053 new and 18,784 follow ups) (ie.2,084 per year), costing the local primary care trust (PCT) a total of £2,103,117. There were also 3474 OPAs made with the gastrointestinal (GI) surgeons (1,409 new and 2,065 follow ups) (ie. 347 per year), costing the local PCT a total of £603,524. In addition a further 42,276 (63%) OPAs were made with non-GI teams, costing the PCT an further £4,227,600.
Conclusion Over 10 years the 2680 patients made 66,007 outpatient clinic visits (24.6 per person, 2.46 per person per year) costings a total of £6,934,241. Of these, 24,311 (37%) were with the GI medics and surgeons, costing the PCT a total of £2,706,641. Many of the non-GI specialty appointments were made for IBD associated conditions eg. 1510 dermatology OPAs. The 3281 ophthalmology OPAs were predominantly for cataracts, which raised concerns about potential iatrogenic causes.
Disclosure of Interest None Declared.
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