Unplanned admissions for patients with myeloma in the UK: Low frequency but high costs

Spyros Kolovos; Guido Nador; Bhuvan Kishore; Matthew Streetly; Neil K Rabin; Andrew D Chantry; Kwee Yong; John Ashcroft; Stella Bowcock; Mark T Drayson; Karthik Ramasamy; Daniel Prieto-Alhambra; Cyrus Cooper; M Kassim Javaid; Rafael Pinedo-Villanueva

doi:10.1016/j.jbo.2019.100243

Unplanned admissions for patients with myeloma in the UK: Low frequency but high costs

J Bone Oncol. 2019 Jun 7:17:100243. doi: 10.1016/j.jbo.2019.100243. eCollection 2019 Aug.

Authors

Spyros Kolovos¹, Guido Nador², Bhuvan Kishore³, Matthew Streetly⁴, Neil K Rabin⁵, Andrew D Chantry^{6

7}, Kwee Yong^{5

8}, John Ashcroft⁹, Stella Bowcock¹⁰, Mark T Drayson¹¹, Karthik Ramasamy², Daniel Prieto-Alhambra^{12

13}, Cyrus Cooper^{14

15

16}, M Kassim Javaid¹, Rafael Pinedo-Villanueva¹

Affiliations

¹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Old Rd, Oxford OX3 7LD, UK.
² Oxford University Hospitals NHS Trust, Oxford, UK.
³ Heart of England NHS Foundation Trust, Birmingham, UK.
⁴ Guy's and St. Thomas' NHS Foundation Trust and King's College London, London, UK.
⁵ Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK.
⁶ Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, UK.
⁷ Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
⁸ UCL Cancer Institute, London, UK.
⁹ Department of Haematology, Mid Yorkshire NHS Trust, Wakefield, UK.
¹⁰ King's College Hospital NHS Trust, London, UK.
¹¹ Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
¹² Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
¹³ Grup de Recerca en Malalties Prevalents de l'Aparell Locomotor Research Group and CIBERFes, University Institute for Primary CareResearch Jordi Gol, Universitat Autonoma de Barcelona and Instituto de Salud Carlos III, Barcelona, Spain.
¹⁴ MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
¹⁵ NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹⁶ NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.

Abstract

Background: Multiple myeloma (MM) is associated with high healthcare resource utilisation and increasing hospitalisation rates. The aim of this study was to characterise the hospital use by patients with MM in the English National Health Service (NHS).

Methods: Routinely-collected aggregate data about all NHS-funded hospital admissions of patients with MM were analysed. Data were obtained from the English Hospital Episodes Statistics on admissions between 1 April 2014 and 31 March 2018.

Results: A total of 754,345 admissions were reported over four years, equivalent to a mean of 188,586 admissions per year. Of the 41,845 patients admitted during this period, 42% were women and 58% men. From the total admissions, 90% were elective and 10% unplanned. Mean annual estimated costs over the period were £46 million for elective and £56 million for unplanned admissions. The number of elective admissions increased by 4.5% with costs increasing 1.5% per year; for unplanned admissions, these figures were 4.1% and 9.0%, respectively.

Conclusions: MM is associated with a significant number of hospital admissions and NHS costs. The majority of the hospital admissions are elective, but the highest burden in terms of costs relates to unplanned admissions, with numbers increasing over time.

Keywords: Costs; Elective admissions; Multiple myeloma; Unplanned admissions.

Abstract

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