The financial burden of stone disease management: How much does urolithiasis cost the Clinical Commissioning Groups (CCGs) in England?
Author(s):
Mr Shalom Srirangam
,
Mr Shalom Srirangam
Affiliations:
Miss Dora Moon
,
Miss Dora Moon
Affiliations:
Mr David Wells
Mr David Wells
Affiliations:
BAUS ePoster online library. Srirangam S. 06/26/17; 177358; P3-2 Disclosure(s): Nothing to declare
Mr. Shalom Srirangam
Mr. Shalom Srirangam
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Abstract
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Introduction:
Urolithiasis represents a significant financial burden for the NHS in England. CCGs are responsible for the planning, commissioning and funding of healthcare services. We seek to estimate the direct financial burden of stone management provision to the English CCGs.

Methods:
We interrogated Dr Foster Intelligence (http://www.drfoster.com), a publically available provider of hospital information to identify urolithiasis related elective and non-elective activity for 12-months (April 2015-March 2016). Data was obtained on numbers of ureteroscopy, PCNL, ESWL and patients with no procedures performed but were admitted with a renal and/or ureteric calculi (ICD-10 codes N20/N23). Procedure re-imbursement is based on NHS National Payment Tariffs.

Results:
There are 209 CCGs in England covering a population of 56,993,527 people with the average CCGs representing 272,696 (740045-917953). See table for the results.

The cost of direct elective stone-related procedure for CCGs exceeds £64 million. There is no clear re-imbursement data available for non-elective hospital episodes but the direct costs is estimated to be >£200 million/year. In addition, there are no urolithiasis-related indirect costs data available.

Conclusions:
Kidney stones place enormous financial demands on the English NHS but there is a critical lack of robust financial data (especially indirect costs). Co-ordinated action is necessary to quantify costs to enable development of a multi-pronged approach including improved understanding of treatment cost-effectiveness, stone recurrence strategies, appropriate workforce planning and the development of national strategies to reduce the financial impact of urolithiasis.
Introduction:
Urolithiasis represents a significant financial burden for the NHS in England. CCGs are responsible for the planning, commissioning and funding of healthcare services. We seek to estimate the direct financial burden of stone management provision to the English CCGs.

Methods:
We interrogated Dr Foster Intelligence (http://www.drfoster.com), a publically available provider of hospital information to identify urolithiasis related elective and non-elective activity for 12-months (April 2015-March 2016). Data was obtained on numbers of ureteroscopy, PCNL, ESWL and patients with no procedures performed but were admitted with a renal and/or ureteric calculi (ICD-10 codes N20/N23). Procedure re-imbursement is based on NHS National Payment Tariffs.

Results:
There are 209 CCGs in England covering a population of 56,993,527 people with the average CCGs representing 272,696 (740045-917953). See table for the results.

The cost of direct elective stone-related procedure for CCGs exceeds £64 million. There is no clear re-imbursement data available for non-elective hospital episodes but the direct costs is estimated to be >£200 million/year. In addition, there are no urolithiasis-related indirect costs data available.

Conclusions:
Kidney stones place enormous financial demands on the English NHS but there is a critical lack of robust financial data (especially indirect costs). Co-ordinated action is necessary to quantify costs to enable development of a multi-pronged approach including improved understanding of treatment cost-effectiveness, stone recurrence strategies, appropriate workforce planning and the development of national strategies to reduce the financial impact of urolithiasis.
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