Chronic subdural haematoma: a UK cost description analysis.

Abstract

Purpose: Chronic subdural haematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence. Most cSDH occur in patients with complex perioperative needs and emerging clinical practice guidelines could provide substantial benefit. This study sought to understand current and future health service costs to inform guideline implementation.

Materials and methods: Using data from the Cambridge University Hospital neurosurgical network, national audit reports, and UK unit cost data, we modelled the total national cost of operative cSDH treatment in 5-year intervals to 2040. Estimates were adjusted for inflation (2.5%) and demographic change (Office for National Statistics). We also modelled potential savings from reductions in hospital length of stay (5 - 40%) and post-discharge care costs (2.5 - 10%).

Results: In 2025, operative cSDH is estimated to cost £15,100 per case and £42,150,000 across the UK, rising by 45% and 88% by 2040, respectively. A 20% reduction in neurosciences unit length-of-stay and 5% reduction in post-discharge costs could save £1,220 per case and £3,395,000 UK wide in 2025. This will rise approximately two-fold by 2040.

Conclusion: cSDH has a significant, and increasing, economic impact. Implementing integrated multidisciplinary care could yield monetary savings as well as additional benefits, such as increased operative capacity.