High burden of hospital resource utilization in patients with hidradenitis suppurativa in England: a retrospective cohort study using hospital episode statistics

Background The health resource utilization associated with managing patients with hidradenitis suppurativa (HS) in England is unknown. Objectives To describe the characteristics of patients with HS and hospital resource use associated with management of HS in England. Methods A retrospective cohort study using Hospital Episode Statistics data. Patients with a primary diagnostic code for HS (ICD-10 code L73.2) during an inpatient admission (n = 11 359) between 1 April 2007 and 31 December 2013 were identified; patients with code L73.2 attending only as outpatients were excluded. Data for all inpatient, outpatient and accident and emergency admissions during the study period were extracted. Results Of the 11 359 patients, 10 832 had a first recorded inpatient HS diagnostic code (index spell) during the study period (female 7569, 69.9%). The mean age at the index spell was 39 +/- 13.1 years in men and 36 +/- 11.7 years in women. There were 65 544 inpatient spells during the study period; 7202 (63.4%) patients underwent nonelective spells, 4128 (36.3%) elective spells and 9790 (86.2%) day-case attendances. There were 43 773 accident and emergency attendances during the study period in 8716 (76.7%) patients. There were 303 204 outpatient appointments in 11 203 patients (mean 27.1 per patient); 4827 (42.5%) of the study population attended dermatology, 8087 (71.2%) general surgery and 4111 (36.2%) plastic surgery. Based on the mean number of spells per patient per year, the mean hospital resource utilization cost for a patient with HS was 2027 pound per patient per year. Conclusions HS is associated with a large burden of hospital attendances for young patients of working age and high National Health Service resource costs.