Hospital Resource Usage and Costs for Patients With Sickle Cell Disease in England: a 10-year Cohort Analysis

Sickle cell disease (SCD) is one of the most prevalent serious genetic conditions in England. Increased patient numbers and more intensive management is thought to have resulted in higher demand for hospital services. This study attempts to quantify this increase.Data from the Hospital Episodes Statistics (HES) Admitted Patient Care (APC) and Outpatient (OP) datasets for patients with a diagnosis of SCD during the 10-year period January 2009 to December 2018 were extracted. Two sub-groups were defined, ‘high crises’ and ‘high transfusions’, with all other patients assigned to the ‘other SCD’ group. Analysis of hospital resource use in the three sub-groups was undertaken. Overall patient numbers increased by 9.9% (9,615 to 10,570) and treatment costs by 82% (£41.9m to £76.4m) over the ten-year period. Disproportionately greater: patient numbers and costs were observed in the two sub-groups of interest. In the high crises sub-group, patient numbers increased by 43% (1,194 to 1,713) and treatments costs by 310% (£9.4m to £38.5m), with corresponding increases of 187% (205 to 589) and 236% (£2.8m to £9.4m) in the high transfusions patients sub-group.Prevalence of sickle cell disease in England continues to grow resulting in significant demand on NHS services. Patients categorised as high crises and high transfusions are consistently greater users of hospital resource and account for the majority of NHS hospital expenditure.