Research blog: Uncovering the cost burden of cellulitis for the NHS in Wales

A 20-year population-scale study of patients with cellulitis, published in the International Wound Journal, has revealed the full economic cost burden for the NHS in Wales.

Caused by bacterial infection, cellulitis can make skin, anywhere on the body, painful, hot or swollen, sometimes accompanied by blistering. Cellulitis accounts for a significant financial and resource cost to the NHS as well as a large proportion of hospital bed occupancy.

This research highlights the potential benefits, to the NHS, to improve diagnosis and treatment pathways for cellulitis.

The research was led by Swansea University’s Senior Research Officer and Health Economist, Ioan Humphreys, and funded by Health Data Research UK. The study team was comprised of researchers from Swansea University and Swansea Bay University Health Board.

In this blog, Ioan Humphreys tells us more about the findings of the research and how SAIL Databank facilitated the analysis…

Economic perspectives on clinical conditions can be important at local, national and global levels. This is the first attempt to estimate the economic burden of cellulitis using the SAIL Databank for both primary and secondary care costs in the Welsh NHS.

The direct costs are considerable (£28 554 338) and would represent 0.35% of the annual budget in Wales. In-Patient events and length of stay costs are the main cost drivers with annual estimates of £19 664 126. This is followed by primary care costs of £8 890 212.

This study used data available within the SAIL Databank, covering nearly 80% of primary care data of the Welsh population, and 100% of secondary care data. Extrapolations made from this are likely to represent a realistic estimate of the problem.

Whilst the population of Wales and the respective Welsh NHS is smaller in comparison to England in the UK, with health being a devolved matter, we believe there is strength in the joined up of nature of services and data availability in Wales, which enables translatable findings which are reflective of the UK NHS as a whole since practice in relation to cellulitis and overall demographics are similar.

Cellulitis is a common and expensive problem for the NHS. This large data analysis showed that estimated annual direct costs for NHS Wales are substantial (over £28 million). Extrapolated for the UK, this amounts to over £571 million. In-Patient events and length of stay costs are the main cost drivers, with annual Welsh NHS estimates of £19 664 126 with primary care events costing £8 890 212. Initiatives to identify early signs/risks of cellulitis, improving the accuracy of initial diagnosis, and improved evidence-based treatment pathways to reduce incidence and severity by even small percentages would result in major financial savings and reduce the burden on patients.

Using the SAIL Databank for this study was crucial to accurately gauging the economic burden of cellulitis. Utilising the coding to link the patients through from primary care to secondary care was invaluable to us as health services researchers. This piece of work has also led to further SAIL Databank Lymphoedema related analyses which is currently being written up by the same group of researchers.

The full research publication can be found here – https://onlinelibrary.wiley.com/doi/10.1111/iwj.14088

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