title: Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?
abstract: OBJECTIVE
  To assess how many hospital visits primary prophylaxis with clotting factor could prevent.
  
  
  METHODS
  The potential for reducing hospital visits was assessed by comparing rates of in-patient, Out-patient and day-case visits per patient-year for individuals with severe (< 1 IU dL-1) haemophilia who had never received primary prophylaxis with attendance rates for individuals with mild/moderate (1-50 IU dL-1) haemophilia. Hospital attendance data were collected retrospectively for the period 1988-97 inclusive for individuals who were aged 18 years or over.
  
  
  METHODS
  Data were obtained on patients who were registered at the Katharine Dormandy Haemophilia Centre (KDHC), London, UK.
  
  
  METHODS
  In-patient stays, Out-patient and day-case visits.
  
  
  RESULTS
  Individuals with mild/moderate haemophilia were 45% (31-56), 36% (30-41) and 70% (68-73) less likely to have required in-patient, Out-patient and day-case visits than were individuals with severe haemophilia. HIV serostatus and age were also shown to be significant and independent predictors of the rate of Out-patient and day-case visits, but not the rate of in-patient stays.
  
  
  CONCLUSIONS
  These results suggest that primary prophylaxis for individuals with severe haemophilia could significantly reduce the demand for in-patient stays, and Out-patient and day-case visits.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK. alec@rfhsm.ac.uk
authors.forename: A H
authors.initials: AH
authors.lastname: Miners
authors.forename: C A
authors.initials: CA
authors.lastname: Sabin
authors.forename: K H
authors.initials: KH
authors.lastname: Tolley
authors.forename: C A
authors.initials: CA
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003631:Day Care, Medical / Q000706:statistics & numerical data*; D005164:Factor IX / Q000008:administration & dosage*; D005169:Factor VIII / Q000008:administration & dosage*; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006467:Hemophilia A / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008131:London; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014600:Utilization Review
chemical_list: D005169:Factor VIII; D005164:Factor IX