Health Care Utilisation in a Cohort of Patients with Primary and Secondary Antibody Deficiency in the United Kingdom.

Autor: Dimbleby B; Clinical Immunology Service, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK., Greenway W; Clinical Immunology Service, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK., Burns SO; Department of Immunology, Royal Free London NHS Foundation Trust, London, UK.; Institute of Immunity and Transplantation, University College London, London, UK., Richter AG; Clinical Immunology Service, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK.; Department of Clinical Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Shields AM; Clinical Immunology Service, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK. a.m.shields@bham.ac.uk.; Department of Clinical Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. a.m.shields@bham.ac.uk.
Jazyk: angličtina
Zdroj: Journal of clinical immunology [J Clin Immunol] 2024 Sep 27; Vol. 45 (1), pp. 18. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1007/s10875-024-01809-3
Abstrakt: Introduction: This study investigates the frequency of hospital attendances, emergency care attendances and geographical influences on service interaction in cohorts of patients with primary and secondary antibody deficiency, to inform future service planning and delivery.
Methods: The COVID-19 in Antibody Deficiency (COV-AD) study was a United Kingdom study that enrolled 525 participants between April 2021 and September 2022. Data on health care utilisation was extracted from a screening cohort of participants at one participating site (Birmingham, UK). Hospital attendance (i.e. all outpatient and inpatient care episodes, including hospital-based IVIG treatment) and emergency care attendance patterns were analysed. Geographical differences in travel times to hospitals and associated costs were considered for all participants at all recruiting sites.
Results: Individuals with antibody deficiency had a median of 7 hospital attendances per year. A diagnosis of secondary antibody deficiency, and antibody deficiency severe enough to require treatment with immunoglobulin replacement were associated with an increased frequency of hospital attendance. 12.7% of the cohort attended the Emergency Department at least once in the preceding twelve months. Individuals with secondary antibody deficiency were at greater risk of requiring emergency care over the preceding one-year and five-year periods. Individuals receiving subcutaneous immunoglobulin lived further from their local immunology centre and were more likely to engage with the COV-AD research study remotely, via dried blood spots sampling.
Conclusion: This study highlights the utilisation of emergency and secondary care usage amongst patient with immunodeficiency and may inform service adaptation and development to better accommodate patient needs and circumstances.
(© 2024. The Author(s).)
Databáze: MEDLINE
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