Presentation (CTI)

OBJECTIVES: There is limited evidence on the extent to which preventive interventions can influence current and future demand for NHS services. To understand this, we first need to characterise healthcare resource utilisation (HCRU) before and after diagnosis across a range of cardiovascular diseases (CVD) including heart failure, atrial fibrillation and stroke. This foundational analysis will inform further collaborative projects evaluating the potential impact of prevention policies.
METHODS: We conducted a retrospective cohort study using primary care electronic medical records from Clinical Practice Research Datalink (CPRD) Aurum linked to Hospital Episode Statistics (HES) secondary care administrative data. Adults (≥18 years) with a first diagnosis between 1^st January 2000 and 1^st September 2024 were included. For each condition, the index date was defined as the date of first recorded diagnosis. HCRU was reported annually over the five years prior to and ten years following diagnosis, including primary care consultations, inpatient admissions, outpatient appointments, A&E attendances, and diagnostic imaging.
RESULTS: We identified 3,111,603 individuals with a first diagnosis of CVD. HCRU increased over the 15-year observation period across all conditions. HCRU peaked in the first-year post-diagnosis, before declining but remaining higher than in the pre-diagnosis period. The peak in HCRU post-diagnosis was most pronounced in primary care, diagnostic imaging, and outpatient settings. Additionally, for several conditions, we observed an increase in HCRU in the year preceding the diagnosis. This trend persisted across all settings except A&E attendances and was most pronounced in individuals diagnosed with heart failure.
CONCLUSIONS: Our findings show substantial increases in HCRU following a CVD diagnosis, particularly in the first year. These descriptive trends provide a foundation for modelling the potential impact of preventive strategies on NHS resource demand.