Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?
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.
Miners
A H
AH
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK. alec@rfhsm.ac.uk
Sabin
C A
CA
Tolley
K H
KH
Lee
C A
CA
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
D005169:Factor VIII; D005164:Factor IX