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Chronic subdural haematoma: a UK cost description analysis
Joseph Dulleston1, Garry Barton2, Benjamin M Davies3
1School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Insights
Chronic subdural haematoma (cSDH) treatment costs are rising significantly in the UK. Implementing multidisciplinary care can reduce costs and improve capacity for this common neurosurgical condition.
Area of Science:
- Neurosurgery
- Health Economics
- Public Health Policy
Background:
- Chronic subdural haematoma (cSDH) is a common neurosurgical condition with increasing incidence.
- Patients with cSDH often have complex perioperative needs.
- Clinical practice guidelines can significantly benefit cSDH management.
Purpose of the Study:
- To estimate the current and future national health service costs associated with operative cSDH treatment.
- To inform the implementation of clinical practice guidelines for cSDH.
- To model potential cost savings through improved care pathways.
Main Methods:
- Utilized data from Cambridge University Hospital, national audit reports, and UK unit cost data.
- Modeled national costs of operative cSDH treatment in 5-year intervals up to 2040.
- Adjusted estimates for inflation and demographic changes, and modeled savings from reduced length of stay and post-discharge care.
Main Results:
- Estimated operative cSDH cost in the UK: £15,100 per case and £42,150,000 nationally in 2025.
- Projected cost increases of 45% and 88% by 2040.
- A 20% reduction in length of stay and 5% in post-discharge costs could save £1,220 per case and £3,395,000 nationally in 2025, with savings doubling by 2040.
Conclusions:
- Chronic subdural haematoma presents a substantial and growing economic burden.
- Implementing integrated multidisciplinary care for cSDH can lead to significant cost savings.
- Improved care pathways offer potential for increased operative capacity alongside financial benefits.
Purpose:
Chronic subdural haematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence. Most cSDH occur in patients with complex perioperative needs and emerging clinical practice guidelines could provide substantial benefit. This study sought to understand current and future health service costs to inform guideline implementation.
Materials And Methods:
Using data from the Cambridge University Hospital neurosurgical network, national audit reports, and UK unit cost data, we modelled the total national cost of operative cSDH treatment in 5-year intervals to 2040. Estimates were adjusted for inflation (2.5%) and demographic change (Office for National Statistics). We also modelled potential savings from reductions in hospital length of stay (5 - 40%) and post-discharge care costs (2.5 - 10%).
Results:
In 2025, operative cSDH is estimated to cost £15,100 per case and £42,150,000 across the UK, rising by 45% and 88% by 2040, respectively. A 20% reduction in neurosciences unit length-of-stay and 5% reduction in post-discharge costs could save £1,220 per case and £3,395,000 UK wide in 2025. This will rise approximately two-fold by 2040.
Conclusion:
cSDH has a significant, and increasing, economic impact. Implementing integrated multidisciplinary care could yield monetary savings as well as additional benefits, such as increased operative capacity.
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