Ghosh Nivedita, Premchand Purushothaman
Queen's Hospital, Barking, Havering & Redbridge Hospitals NHS Trust, Romford, UK.
Frontline Gastroenterol. 2015 Jul;6(3):169-174. doi: 10.1136/flgastro-2014-100514. Epub 2015 Feb 24.
There are an estimated 620 000 patients with inflammatory bowel disease (IBD) in the UK. The rising incidence of IBD combined with its incurability has significant cost implications. The aim of this cost of care model was to calculate the annual cost per adult patient of treating ulcerative colitis (UC) and Crohn's disease (CD) from a NHS perspective, and to enable areas of potential cost savings to be explored.
The cost of IBD was calculated by summing the costs of treatment, treatment side effects and disease-related complications, accounting for the proportions of patients incurring these costs. Default input values for costs, the percentage of patients receiving each treatment, and the percentage of patients experiencing treatment-related side effects or disease-related complications were determined from national sources and published literature. However, the model permitted the user to input local or alternative data.
The model was designed to be used by NHS trusts in the UK.
Using default input values, the annual cost of treating any patient with UC was estimated to be £3084. For a patient with UC in remission, in relapse with mild-to-moderate UC or in relapse with severe UC, annual cost per patient was estimated to be £1693, £2903 and £10 760, respectively. The annual cost for any patient with CD was estimated to be £6156 (£1800 for patients in remission; £10 513 for patients in relapse).
While IBD remains a costly condition with modest potential cost savings, this model facilitates calculation of annual costs per patient with UC and CD, and its customisability will help hospitals identify areas where savings could be made.
据估计，英国有62万炎性肠病（IBD）患者。IBD发病率不断上升且无法治愈，这带来了巨大的成本影响。本护理成本模型的目的是从英国国家医疗服务体系（NHS）的角度计算成年溃疡性结肠炎（UC）和克罗恩病（CD）患者的年度治疗成本，并探索潜在的成本节约领域。
IBD的成本通过汇总治疗成本、治疗副作用和疾病相关并发症的成本来计算，并考虑到产生这些成本的患者比例。成本的默认输入值、接受每种治疗的患者百分比以及出现治疗相关副作用或疾病相关并发症的患者百分比是根据国家来源和已发表的文献确定的。然而，该模型允许用户输入本地或替代数据。
该模型旨在供英国的NHS信托机构使用。
使用默认输入值，估计每位UC患者的年度治疗成本为3084英镑。对于缓解期的UC患者、轻度至中度UC复发患者或重度UC复发患者，每位患者的年度成本估计分别为1693英镑、2903英镑和10760英镑。每位CD患者的年度成本估计为6156英镑（缓解期患者为1800英镑；复发患者为10513英镑）。
虽然IBD仍然是一种成本高昂的疾病，潜在的成本节约空间不大，但该模型有助于计算UC和CD患者的年度成本，其可定制性将有助于医院确定可以节省成本的领域。
