George Moussa1,2, James Hodson3, Nick Gooch4, Jasvir Virdee1,2, Cristina Penaloza4, Jesse Kigozi4, Saaeha Rauz5,6. 1. Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. 2. Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. 3. Department of Biostatistics, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 4. Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK. 5. Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. s.rauz@bham.ac.uk. 6. Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. s.rauz@bham.ac.uk.
Abstract
PURPOSE: Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency admission in the UK. However, few prospective health-economic studies of MK have been performed, and no specific healthcare resources group (HRG) code exists. This study is designed to determine the feasibility of a data collection tool derived from the microbiology ophthalmology group (MOG) clinical record form, to enable quantification of direct costs of inpatient care, as well as prospective capture of epidemiological data relating to outcomes of MK. METHODS: Clinical, demographic and economic data were collected retrospectively between January and December 2013 for 101 consecutive patients admitted with MK, using an adaption of the MOG toolset. The direct cost of admission (COA) was calculated using national reference costs and compared to actual income to generate profit/deficit profiles for individual patients. Indices of multiple deprivation were used to assess effect of deprivation on the COA. RESULTS: The total income generated through discharge coding was £252,116, compared to a COA of £357,075, yielding a deficit of £104,960 (median: £754 per patient). The cost deficit increased significantly with length of stay (LOS, p < 0.001), whilst patients with short LOS were income generators; cost neutrality occurred at 4.8 days. Greater socioeconomic deprivation was also associated with a significantly higher cost deficit. CONCLUSION: LOS is the key driver for COA of care for MK admissions. Protocols should encourage discharge of patients who are able to self-administer treatment after the sterilisation phase. The MOG-derived data collection toolset captures pertinent clinical data for quantification of COA. Further development into a multiuser and multisite platform is required for robust prospective testing, together with expansion to capture indirect costs of disease burden, including impact of treatment, visual morbidity and quality of life.
PURPOSE: Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency admission in the UK. However, few prospective health-economic studies of MK have been performed, and no specific healthcare resources group (HRG) code exists. This study is designed to determine the feasibility of a data collection tool derived from the microbiology ophthalmology group (MOG) clinical record form, to enable quantification of direct costs of inpatient care, as well as prospective capture of epidemiological data relating to outcomes of MK. METHODS: Clinical, demographic and economic data were collected retrospectively between January and December 2013 for 101 consecutive patients admitted with MK, using an adaption of the MOG toolset. The direct cost of admission (COA) was calculated using national reference costs and compared to actual income to generate profit/deficit profiles for individual patients. Indices of multiple deprivation were used to assess effect of deprivation on the COA. RESULTS: The total income generated through discharge coding was £252,116, compared to a COA of £357,075, yielding a deficit of £104,960 (median: £754 per patient). The cost deficit increased significantly with length of stay (LOS, p < 0.001), whilst patients with short LOS were income generators; cost neutrality occurred at 4.8 days. Greater socioeconomic deprivation was also associated with a significantly higher cost deficit. CONCLUSION: LOS is the key driver for COA of care for MK admissions. Protocols should encourage discharge of patients who are able to self-administer treatment after the sterilisation phase. The MOG-derived data collection toolset captures pertinent clinical data for quantification of COA. Further development into a multiuser and multisite platform is required for robust prospective testing, together with expansion to capture indirect costs of disease burden, including impact of treatment, visual morbidity and quality of life.
Authors: Sarah A Collier; Michael P Gronostaj; Amanda K MacGurn; Jennifer R Cope; Kate L Awsumb; Jonathan S Yoder; Michael J Beach Journal: MMWR Morb Mortal Wkly Rep Date: 2014-11-14 Impact factor: 17.586
Authors: George Moussa; Muhammed Omar Qadir; Soon Wai Ch'ng; Kim Son Lett; Arijit Mitra; Ajai K Tyagi; Ash Sharma; Walter Andreatta Journal: Spektrum Augenheilkd Date: 2022-05-24
Authors: George Moussa; Dimitrios Kalogeropoulos; Soon Wai Ch'ng; Kim Son Lett; Arijit Mitra; Ajai K Tyagi; Ash Sharma; Walter Andreatta Journal: PLoS One Date: 2021-11-09 Impact factor: 3.240
Authors: Jeremy J Hoffman; Reena Yadav; Sandip Das Sanyam; Pankaj Chaudhary; Abhishek Roshan; Sanjay K Singh; Sailesh K Mishra; Simon Arunga; Victor H Hu; David Macleod; Astrid Leck; Matthew J Burton Journal: Front Med (Lausanne) Date: 2022-07-22