Team:Dundee/Implementation/financial

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               <h1>Financial Savings</h2>
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               <h1>Quantitative Impact</h2>
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             <p class="lead">What we can save</p>
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             <p class="lead">CF in Numbers</p>
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             <li class="list-group-item"><a href="#0" class="">Initial planning and cloning strategy</a>
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             <li class="list-group-item"><a href="#0" class="">Introduction</a>
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<h2 id="0">Introduction </h2>
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To get a better understand of how the L.A.S.S.O. could be implemented into society we constructed several financial models. We followed the idealistic view that The Lung Ranger, and more specifically the implemented L.A.S.S.O., could give a quicker quantitative bacterial load within patients’ lung infections. This would enable faster eradication, and thus create a healthier CF community requiring less hospital treatment. We used the data available from the CF Registry <a href="http://www.cysticfibrosis.org.uk/media/598466/annual-data-report-2013-jul14.pdf">2013 Annual Report</a> and investigated the amount of time CF patients spend on IV treatment at home and at the hospital. We then introduced our hypotheses; the L.A.S.S.O. could decrease the IV treatment duration by 10%, 30% and 50%. Following this idea through we were able to see the impact of this with regards to the scale of the CF patient community, the NHS and the UK.
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An important aspect of how the L.A.S.S.O. could be usefully implemented into society was to understand the associated costs. Hence we constructed several financial models. We started by following the assumption that The Lung Ranger, and more specifically the implemented L.A.S.S.O., would yield faster, quantitative bacterial load readings than is possible with the present testing procedure. This would lead to faster treatment and thus create a healthier CF community requiring less hospital treatment. We used the data available from the CF Registry <a href="http://www.cysticfibrosis.org.uk/media/598466/annual-data-report-2013-jul14.pdf">2013 Annual Report</a> and investigated the amount of time CF patients spend on IV treatment at home and at the hospital. We then introduced three test hypotheses: successful implementation of the L.A.S.S.O. could decrease the IV treatment duration by 10%, 30% and 50%, respectively. Following through with this idea we were able to see the impact this had with regards to the scale of the CF patient community, the UK National Health Service (NHS) and ‘UK PLC’.
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The CF patients remained at the core of our project. Thus, we wanted to look into the days off the CF community would need on an annual scale based around IV treatment. Within this we constructed two models; one based on the paediatric CF patients, Fig 2, and one based on those aged 16 or above in employment or full time study, Fig 1.
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<h2 id="1">Models</h2>
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The CF patients remained at the core of our project; during our visits to the clinics, many patients expressed that they would rather continue treatment at home than in hospital when possible. This would help to minimise disruption to their working lives, the feeling of isolation in hospital and help to give patients some autonomy over their condition. Thus, we wanted to quantify the number of days a typical member of the CF community was absent from work/school for hospital IV treatment on an annual basis. We constructed two models; one based on the paediatric CF patients, Fig 1, and one based on those aged 16 or above in employment or full time study, Fig 2.
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Currently on average, a working or studying CF patient is losing out 40 days a year based on their IV treatment. A month and a half contributes to a big loss in work load. With 10% implementation these days could be cut down to 36 days, and then with 50% of the length of IV treatment cut down by The Lung Ranger this could cut down to 20 days.
 
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Furthermore, a child with CF spends on average 30 days annually getting IV treatment; possibly missing school days. With 10% implementation these days could be cut down to 27 days. With 50% of the length of IV treatment cut down by The Lung Ranger this could cut down to 15 days changing the time lost from a month to a fortnight.  
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Currently on average, a working or studying CF patient is losing 40 days a year to IV treatment. With 10% implementation, these days could be cut down to 36 days, and then with 50% of the length of IV treatment cut down by The Lung Ranger this could cut down to 20 days.  
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Whilst regarding the costs related to the NHS we looked into the cost associated with one day of hospitalization which was £264<sup>1</sup>. We looked into the average number of days for which patients are hospitalized along with the number of patients and computed the hypotheses alongside this data. From this we concluded that if the length of hospitalized IV treatment could be cut down by 10%, on the scale of the registry it could save £1.5 million. However, if the long term tracking of lung infections could cut down the length of hospitalized IV treatment by 50%, the cost could be cut by half thus saving £7.7 million.  
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Furthermore, a child with CF spends on average 30 days annually getting IV treatment; regularly missing school days due to the Monday-Friday schedule of clinics. With 10% implementation these days could be cut down to 27 days. With the length of IV treatment reduced by 50% by The Lung Ranger this could cut down to 15 days, changing the time lost from a month to a fortnight.
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Whilst regarding the costs related to the NHS we investigated the cost associated with one day of hospitalization, which we discovered to be £264 per patient <sup>1</sup>. We looked into the average number of days for which patients are hospitalized along with the number of patients and computed the reduction-hypotheses alongside this data. From this we concluded that if the length of hospitalized IV treatment could be cut down by 10%, it could save £1.5 million in costs for those patients on the CF Registry. However, if the long term tracking of lung infections could cut down the length of hospitalized IV treatment by 50%, the cost could be cut by half thus saving £7.7 million (Fig 3).
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Finally, to investigate the implementation of the L.A.S.S.O. on the scale of the UK we considered the hours off work CF patients had to take due to IV treatment and the country’s Gross Domestic Product (GDP). We considered the GDP per person of the UK which is £22,336<sup>2</sup> along with the average number of hours worked annually per employee in the UK; 1,669 hours<sup>3</sup>. From this we were able to estimate the average contribution of a person towards the GDP per hour, which was £13.38. Currently due to IV treatment the hours off work that CF patients are missing contribute to a loss in £26M to the UK GDP. From this we considered the possible recovered contribution in GDP based on our L.A.S.S.O. hypotheses, Fig 4.
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<h2 id="2">Conclusions</h2>
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If the L.A.S.S.O. could be successfully implemented at reasonable cost, the saving to the NHS and the wider financial benefits to society would be significant. However, most importantly,  the successful implementation of a rapid diagnostic testing device, would allow mature CF patients to play a far greater and more active role in the workplace and those of school age to take full advantage of their educational and social opportunities.
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             <h3>References</h3>     
             <h3>References</h3>     
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<sup>1</sup> https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213060/2011-12-reference-costs-publication.pdf
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<sup>1</sup> UK Government (2012) <i>UK Government Reference Costs 2011-2012</i> [Online] Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213060/2011-12-reference-costs-publication.pdf [Accessed: 13th October 2014]<br/>
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<sup>2</sup>
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BBC News (2013) <i>Scotland in numbers</i> [Online] Available from: http://www.bbc.co.uk/news/uk-scotland-24866266 [Accessed: 13th October 2014]<br/>
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<sup>3</sup> OECD.StatExtracts (2013) <i>Average annual hours worked per worker</i> [Online] Available from: http://stats.oecd.org/index.aspx?DataSetCode=ANHRS [Accessed: 13th October 2014]
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Latest revision as of 22:31, 17 October 2014

Dundee 2014

Dundee 2014

Quantitative Impact

CF in Numbers

Introduction

An important aspect of how the L.A.S.S.O. could be usefully implemented into society was to understand the associated costs. Hence we constructed several financial models. We started by following the assumption that The Lung Ranger, and more specifically the implemented L.A.S.S.O., would yield faster, quantitative bacterial load readings than is possible with the present testing procedure. This would lead to faster treatment and thus create a healthier CF community requiring less hospital treatment. We used the data available from the CF Registry 2013 Annual Report and investigated the amount of time CF patients spend on IV treatment at home and at the hospital. We then introduced three test hypotheses: successful implementation of the L.A.S.S.O. could decrease the IV treatment duration by 10%, 30% and 50%, respectively. Following through with this idea we were able to see the impact this had with regards to the scale of the CF patient community, the UK National Health Service (NHS) and ‘UK PLC’.

Models

The CF patients remained at the core of our project; during our visits to the clinics, many patients expressed that they would rather continue treatment at home than in hospital when possible. This would help to minimise disruption to their working lives, the feeling of isolation in hospital and help to give patients some autonomy over their condition. Thus, we wanted to quantify the number of days a typical member of the CF community was absent from work/school for hospital IV treatment on an annual basis. We constructed two models; one based on the paediatric CF patients, Fig 1, and one based on those aged 16 or above in employment or full time study, Fig 2.



Currently on average, a working or studying CF patient is losing 40 days a year to IV treatment. With 10% implementation, these days could be cut down to 36 days, and then with 50% of the length of IV treatment cut down by The Lung Ranger this could cut down to 20 days.

Furthermore, a child with CF spends on average 30 days annually getting IV treatment; regularly missing school days due to the Monday-Friday schedule of clinics. With 10% implementation these days could be cut down to 27 days. With the length of IV treatment reduced by 50% by The Lung Ranger this could cut down to 15 days, changing the time lost from a month to a fortnight.

Whilst regarding the costs related to the NHS we investigated the cost associated with one day of hospitalization, which we discovered to be £264 per patient 1. We looked into the average number of days for which patients are hospitalized along with the number of patients and computed the reduction-hypotheses alongside this data. From this we concluded that if the length of hospitalized IV treatment could be cut down by 10%, it could save £1.5 million in costs for those patients on the CF Registry. However, if the long term tracking of lung infections could cut down the length of hospitalized IV treatment by 50%, the cost could be cut by half thus saving £7.7 million (Fig 3).



Finally, to investigate the implementation of the L.A.S.S.O. on the scale of the UK we considered the hours off work CF patients had to take due to IV treatment and the country’s Gross Domestic Product (GDP). We considered the GDP per person of the UK which is £22,3362 along with the average number of hours worked annually per employee in the UK; 1,669 hours3. From this we were able to estimate the average contribution of a person towards the GDP per hour, which was £13.38. Currently due to IV treatment the hours off work that CF patients are missing contribute to a loss in £26M to the UK GDP. From this we considered the possible recovered contribution in GDP based on our L.A.S.S.O. hypotheses, Fig 4.



Conclusions

If the L.A.S.S.O. could be successfully implemented at reasonable cost, the saving to the NHS and the wider financial benefits to society would be significant. However, most importantly, the successful implementation of a rapid diagnostic testing device, would allow mature CF patients to play a far greater and more active role in the workplace and those of school age to take full advantage of their educational and social opportunities.

References

1 UK Government (2012) UK Government Reference Costs 2011-2012 [Online] Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213060/2011-12-reference-costs-publication.pdf [Accessed: 13th October 2014]
2 BBC News (2013) Scotland in numbers [Online] Available from: http://www.bbc.co.uk/news/uk-scotland-24866266 [Accessed: 13th October 2014]
3 OECD.StatExtracts (2013) Average annual hours worked per worker [Online] Available from: http://stats.oecd.org/index.aspx?DataSetCode=ANHRS [Accessed: 13th October 2014]