Social Care Use, Characteristics, and Costs of U.K. Rheumatology Outpatient Attenders: Findings From a Data Linkage Pilot of Routinely Collected Health and Social Care Data
Fangyuan Zhang, Louise Cook, Jenny Humphries, Warren Del-Pinto, Elaine Mackey, William G. Dixon, Paul ClarksonIntroduction
Musculoskeletal conditions burden individuals’ quality of life and health and social care resources. However, we know little about how many of these patients use social care, their characteristics, and costs.
Material and Methods
We used routine administrative data from patients attending a U.K. NHS rheumatology clinic, linked with data from their local authority Adult Social Care contacts. Descriptive analyses were undertaken to determine how many patients used social care, types of services used, level of informal care, support with daily living, and social care costs. Further, regression analyses were used to explore associations between rheumatological diagnosis, patient characteristics, number of comorbidities, and whether patients used social care and its annual costs to the local authority.
Results
Of 15,876 rheumatology outpatients, between June 2013 and November 2020, 297 (2%) used social care services, between January and December 2022. The highest social care receipt was in females, those in older age groups, from more deprived areas, and with more than one musculoskeletal condition; 27% of patients receiving social care had informal care support. The greatest needs for social care were in patients requiring help with managing and maintaining nutrition and managing personal hygiene, with their Primary Support Reason for local authority contact being for personal care, followed by access and mobility. The relationship between rheumatology condition and social care was complex. Patients with autoimmune connective tissue diseases and inflammatory arthritis received more home care, whereas those with autoimmune connective tissue diseases and crystal arthritis were in care homes. Patients’ total annual local authority cost of social care was nearly £5.5M, with significant associations between crystal arthritis, other musculoskeletal disease, more than one musculoskeletal disease, and higher social care costs.
Discussion
Our findings reinforce these patients’ needs for care and support and can facilitate government and local social care planning.