Background: Congenital adrenal hyperplasia (CAH) is a rare disorder of steroid synthesis. Patients have multiple health problems. Healthcare utilisation has not previously been assessed in the paediatric population with CAH.
Objective and hypotheses: To assess healthcare resource use in patients in England with CAH.
Method: The English Clinical Practice Research Datalink (CPRD) database is an observational and interventional research service overseen by the UK Department of Health. Approximately 50% of CPRD patients link to more detailed records than the standard dataset and we selected patients eligible for linkage to Hospital Episode Statistics (HES) data. We analysed data from 351 CAH patients of all ages as defined by Read and ICD-10 coding, alongside 3510 age- and sex-matched controls. Patients resource use and costs were analysed by age group: 51 patients/510 controls 06 years, 33 patients/330 controls 717 years, and compared by Mann-Whitney test. Neonatal utilisations were only captured after a patient was registered with primary care.
Results: Primary care usage was approximately double for paediatric patients compared with controls, with a median 9.0 vs 4.0 consultations/year (P<0.001) in 06 years and 4.0 vs 2.0 consultations/year (P<0.001) in 717 years. Secondary care usage was higher in CAH with higher median outpatient appointments: 8.0 vs 0.0 (P<0.001) (06 years) and 5.0 vs 0.0 (P<0.001) (717 years). Median inpatient admissions were also more common in CAH 2.0 vs 0.0 (P<0.001) (06 years) and 1.0 vs 0.0 (P<0.001) in 717 years.
Conclusion: This study shows a significantly increased healthcare utilisation from CAH throughout childhood. Refining and improving treatment for patients with CAH should help to reduce this burden on the healthcare system.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology