title: Services for erectile dysfunction in the UK - a 12-month review of referrals to a west Midlands NHS clinic.
abstract: BACKGROUND
  Few studies have addressed the health economics of the provision of services for sexual dysfunction within the National Health Service.
  
  
  OBJECTIVE
  To evaluate the referral patterns, workload and prescribing costs in secondary care resulting from government guidance on erectile dysfunction (ED).
  
  
  METHODS
  A review of 324 consecutive referral letters to the Good Hope Hospital Erectile Dysfunction Clinic was conducted to assess the purpose of referral. Prescribing data and costs were assessed over the same 2-year period.
  
  
  RESULTS
  Severe distress was the main reason for referral in 54% of referrals. Long term prescribing according to government guidance doubled the cost of care and created an unsustainable increase in clinic and pharmacy workload.
  
  
  CONCLUSIONS
  Existing regulations designed to control costs of ED therapy have created health inequalities, waste of resources and have increased the overall cost of care.
authors.affiliation: Good Hope Hospital, Sutton Coldfield, UK. geoff.hackett@virgin.net
authors.forename: G
authors.initials: G
authors.lastname: Hackett
authors.forename: N
authors.initials: N
authors.lastname: Cole
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D004739:England; D007172:Erectile Dysfunction / Q000191:economics / Q000628:therapy*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D011306:Prescription Fees; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D013222:State Medicine / Q000191:economics; D013315:Stress, Psychological / Q000191:economics / Q000209:etiology; D016526:Workload