Contributions
Abstract: EP1315
Type: E-Poster Presentation
Session title: Thalassemias
Background
Beta-thalassaemias are a group of hereditary haemogloblin disorders characterized by anomalies in the synthesis of the beta chains of adult haemoglobin resulting in ineffective erythropoiesis (IE) and anaemia. Beta-thalassaemia (BT) is classified clinically as transfusion-dependent (TD) or non-transfusion-dependent (NTD) based on patients red blood cell transfusion (RBCT) needs. IE, anaemia and RBCT treatment can lead to iron overload and various morbidities such as endocrine, liver and cardiac complications.
The Hospital Episodes Statistics (HES) database in England contains universal coverage of secondary care data from NHS hospitals, covering three main patient groups: 1) inpatient patient care; 2) Outpatient appointments and attendances (OP); and 3) Emergency Room (ER) visits with approximately 17 million episodes recorded each year.
Aims
To describe patients diagnosed with BT in England in terms of demographics and clinical characteristics and to quantify the associated healthcare resource use (HCRU) and tariffs for this patient cohort including inpatient, day case, outpatient, and A&E care.
Methods
All data within an observation period between 01 January 2015- 31 December 2019, to include baseline characteristics for patients with ICD10 diagnosis code of D561 or D565 (BT) were extracted from HES and presented as crude counts. Descriptive statistics including frequency and percentage were calculated as categorical variables; whereas, mean, median and interquartile range (IQR) were calculated for continuous variables. Length of follow-up was calculated as the total number of days between diagnosis date (index date) and end of study period. Tariffs were derived based on case mix; a method of classifying patient care based on expected clinical resource use for the provision of that care.
Results
Overall 1,986 patients (mean age at inclusion 28 years [youngest; <1, oldest; 95]; 49.65% female) were identified. During a mean observation period of 35 months (IQR 54), 585 (29.46%) patients experienced a disorder of iron metabolism, 222 (11.18%) suffered from sepsis and 157 (7.91%) from heart failure.
2 (0.10%) patients had no inpatient admissions. For those who had ≥1 inpatient admissions, the mean number of inpatient blood transfusion visits per-patient-per-year was 11.31 (IQR 11.22), the mean number of outpatient blood transfusion visits per-patient-per-year was 17 (IQR 0.84). 1,032 patients (55.81%) had ≥12 blood transfusion visits per year.
Overall HCRU is split by inpatient and outpatient care and ER attendance. In the inpatient setting there were a mean of 14.9 admissions per-patient-per-year, of which 97.57% were elective (resulting in a mean of 4.34 bed days per-patient-per-year). In the outpatient setting there were a mean of 8.9 appointments per-patient-per-year. There were a mean of 5.81 ER visits per-patient-per-year.
Overall tariff costs on the health service per-patient-per-year were £23,120 (inpatient tariff £10,563, outpatient tariff £1,506, transfusion £10,200, ER visits £851).
Conclusion
The results of this database analysis with a large number of patients offer insights into the real-world management of patients with BT in England and the high HCRU associated with its management. A burden on patients and the healthcare system has been identified due to the frequent hospitalisations and secondary care visits. This highlights the need for novel treatment options in the management of BT.
Keyword(s): Beta thalassemia, Thalassemia
Abstract: EP1315
Type: E-Poster Presentation
Session title: Thalassemias
Background
Beta-thalassaemias are a group of hereditary haemogloblin disorders characterized by anomalies in the synthesis of the beta chains of adult haemoglobin resulting in ineffective erythropoiesis (IE) and anaemia. Beta-thalassaemia (BT) is classified clinically as transfusion-dependent (TD) or non-transfusion-dependent (NTD) based on patients red blood cell transfusion (RBCT) needs. IE, anaemia and RBCT treatment can lead to iron overload and various morbidities such as endocrine, liver and cardiac complications.
The Hospital Episodes Statistics (HES) database in England contains universal coverage of secondary care data from NHS hospitals, covering three main patient groups: 1) inpatient patient care; 2) Outpatient appointments and attendances (OP); and 3) Emergency Room (ER) visits with approximately 17 million episodes recorded each year.
Aims
To describe patients diagnosed with BT in England in terms of demographics and clinical characteristics and to quantify the associated healthcare resource use (HCRU) and tariffs for this patient cohort including inpatient, day case, outpatient, and A&E care.
Methods
All data within an observation period between 01 January 2015- 31 December 2019, to include baseline characteristics for patients with ICD10 diagnosis code of D561 or D565 (BT) were extracted from HES and presented as crude counts. Descriptive statistics including frequency and percentage were calculated as categorical variables; whereas, mean, median and interquartile range (IQR) were calculated for continuous variables. Length of follow-up was calculated as the total number of days between diagnosis date (index date) and end of study period. Tariffs were derived based on case mix; a method of classifying patient care based on expected clinical resource use for the provision of that care.
Results
Overall 1,986 patients (mean age at inclusion 28 years [youngest; <1, oldest; 95]; 49.65% female) were identified. During a mean observation period of 35 months (IQR 54), 585 (29.46%) patients experienced a disorder of iron metabolism, 222 (11.18%) suffered from sepsis and 157 (7.91%) from heart failure.
2 (0.10%) patients had no inpatient admissions. For those who had ≥1 inpatient admissions, the mean number of inpatient blood transfusion visits per-patient-per-year was 11.31 (IQR 11.22), the mean number of outpatient blood transfusion visits per-patient-per-year was 17 (IQR 0.84). 1,032 patients (55.81%) had ≥12 blood transfusion visits per year.
Overall HCRU is split by inpatient and outpatient care and ER attendance. In the inpatient setting there were a mean of 14.9 admissions per-patient-per-year, of which 97.57% were elective (resulting in a mean of 4.34 bed days per-patient-per-year). In the outpatient setting there were a mean of 8.9 appointments per-patient-per-year. There were a mean of 5.81 ER visits per-patient-per-year.
Overall tariff costs on the health service per-patient-per-year were £23,120 (inpatient tariff £10,563, outpatient tariff £1,506, transfusion £10,200, ER visits £851).
Conclusion
The results of this database analysis with a large number of patients offer insights into the real-world management of patients with BT in England and the high HCRU associated with its management. A burden on patients and the healthcare system has been identified due to the frequent hospitalisations and secondary care visits. This highlights the need for novel treatment options in the management of BT.
Keyword(s): Beta thalassemia, Thalassemia