Abstract
To identify a PAH patient cohort using the Hospital Episode Statistics (HES) administrative database and evaluate hospital healthcare resource utilisation (HRU) and economic burden of illness in England. An algorithm was developed to identify a PAH cohort. HES data were extracted (01.04.2012 to 31.03.2018) and patients were identified as those diagnosed (index date) alive on the 1st of June of each calendar year. The number of events and associated costs were calculated for Accident & Emergency (A&E), inpatient, and outpatient services. Over 5 complete years, 2,527 patients were identified, compared with 2,695 reported in The UK 5th National Pulmonary Hypertension (PH) Audit. The PAH cohort presented a mean follow-up period of 44.8 months (SD=20.5). Gender (68.4% female) and age distribution aligned well with reported literature and the National PH Audit. The mean age at index was 58.0 years (SD=16.8). In 2017 (1,825 patients), PAH patients had a mean of 0.4 A&E attendances (SD=1.0) with a mean cost of £123.18 (SD=£247.37) per patient. PAH patients had a mean of 1.4 inpatient admissions (SD=4.3) for a mean cost of £3,832.91 (SD=£6,032.14) and a mean length of stay of 3.3 days (SD=7.6). The mean length of hospitalisation was 3.8 days (SD=8.1) for PAH-related events and 2.3 days (SD=6.2) for non-PAH-related events. PAH patients had a mean of 5.0 outpatient visits (SD=7.4) with an associated mean cost of £895.86 (SD=£831.93) per patient. In 2017, the total cost for PAH patients was £8.9m where £7.0m was associated with inpatient admissions. Of the total inpatient admission costs, £5.7m was attributed to PAH-related admissions. The epidemiological characteristics of the PAH cohort in England were in line with reported literature. In 2017, 64.3% of the total inpatient admission costs were for a PAH-related event. In summary, these results confirm that there is an HRU burden across all services.
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