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Hepatology outpatient service provision in secondary care: a study of liver disease incidence and resource costs

Simon Whalley, Prasanthi Puvanachandra, Atman Desai and Hugh Kennedy
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DOI: https://doi.org/10.7861/clinmedicine.7-2-119
Clin Med April 2007
Simon Whalley
1Department of Gastrohepatology, West Suffolk Hospital, Bury St Edmunds
Roles: Consultant Gastrohepatologist
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Prasanthi Puvanachandra
1Department of Gastrohepatology, West Suffolk Hospital, Bury St Edmunds
Roles: Pre-registration House Officer
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Atman Desai
1Department of Gastrohepatology, West Suffolk Hospital, Bury St Edmunds
Roles: Pre-registration House Officer
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Hugh Kennedy
2Norfolk and Norwich University Hospital, Norfolk
Roles: Consultant Gastroenterologist
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Abstract

This paper discusses the annual incidence of liver disease and resource costs in providing a hepatology service for all new outpatient referrals to a secondary care setting. In a retrospective study, we found that 200 patients (1 in 1,000 of the West Suffolk population) with a mean age of 52 years were referred per year. One-third of patients had cirrhosis (almost half due to alcohol). Annual incidence (per 100,000 population) were as follows: non-alcoholic fatty liver disease (29: of which 23.5 non-cirrhotic and 5.5 cirrhotic), hepatitis C (25), hepatitis B (3), alcohol-related cirrhosis (12.5), primary biliary cirrhosis (3.5), autoimmune hepatitis (3), primary sclerosing cholangitis (2), haemochromatosis (2), hepatocellular carcinoma (1.5) and oesophageal variceal haemorrhage (6.5). Using national indicative tariffs, the total annual hepatology budget was £130K (£58K for resources and £72K for clinic attendances). The greatest resource expenditure was on endoscopy (almost half for oesophageal varices) and radiological imaging (one-third of the total budget). These findings will help inform commissioners in hepatology service funding.

  • © 2007 Royal College of Physicians
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Hepatology outpatient service provision in secondary care
Simon Whalley, Prasanthi Puvanachandra, Atman Desai, Hugh Kennedy
Clinical Medicine Apr 2007, 7 (2) 119-124; DOI: 10.7861/clinmedicine.7-2-119

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Hepatology outpatient service provision in secondary care
Simon Whalley, Prasanthi Puvanachandra, Atman Desai, Hugh Kennedy
Clinical Medicine Apr 2007, 7 (2) 119-124; DOI: 10.7861/clinmedicine.7-2-119
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