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PTH-156 Inflammatory Bowel Disease: A 10 Year Review of the Cost and Demand of this Condition, on a District General Endoscopy Unit
  1. M W Johnson1,
  2. K Lithgo1,
  3. T Prouse1,
  4. T Price1
  1. 1Gastroenterology, Luton & Dunstable University Hospital, Luton, UK

Abstract

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 needed 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 by this cohort of patients on 4 key services offered by our local hospital; the endoscopy, radiology, hospital admissions and outpatient services.

Objectives of this study: To assess the cost and demand for endoscopy originating from the management of IBD patients, over a 10 year period.

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 for reference, the hospital coding system was used to analyse the total number of lower gastrointestinal endoscopy procedures performed between 2001 and 2011 on IBD patients. The total cost for the primary care trust (PCT) was then calculated based on the Department of Health National Tariff System, awarding £561 for a diagnostic colonoscopy and £482 for a flexible sigmoidoscopy.

Results Over the 10 year period, the 2680 patients underwent 1835 flexible sigmoidoscopies (1405 in UC patients, 134 in Crohn’s patients and in 296 patients with IBD unspecified) and 1475 colonoscopies (780 in UC patients, 436 in Crohn’s patients and in 259 patients with IBD unspecified). In total this cost the PCT £884,470 for flexible sigmoidoscopy and £827,475 for colonoscopy.

Conclusion Over the course of 10 years the 2680 IBD patients had a total of 3328 lower GI endoscopies (or 332 per year). This cost the local PCT a total of £1,711,945 (or £171,194 per year). A greater utilisation of faecal calprotectin for the assessment of disease activity and treatment monitoring in IBD may help reduce the total number and cost of lower GI endoscopy in this cohort of patients.

Disclosure of Interest None Declared.

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