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AN AUDIT OF THE DIAGNOSIS AND COSTS ASSOCIATED WITH INPATIENTS WITH FUNCTIONAL NEUROLOGICAL SYMPTOMS IN A DISTRICT GENERAL HOSPITAL
  1. M Adjei,
  2. JA Coebergh

Abstract

Objective Functional symptoms are signs of illness which are not associated with any organic cause. Patients with functional symptoms cost the NHS three billion pounds in 2008–9.1 Within neurology alone, functional symptoms represent as much as nine percent of all inpatient episodes.2 Patients with functional neurological symptoms may be difficult to manage and often have multiple hospital admissions. This may contribute to the high costs associated with their care.1 The aims of this audit are twofold. Firstly to assess the hospital stay and investigations undertaken by patients with functional neurological symptoms between 2009 and 2012 at Ashford St Peters Healthcare Trust (ASPH). The total cost of these patients between 2010 and 2012 incurred in one hospital were calculated.

Method This audit was carried out using patient notes and the hospital information system at ASPH. Of the 150 patients admitted to ASPH between February and September 2012, nineteen patients with functional symptoms were identified. Information regarding basic demographics as well as A&E admissions for neurological disease in the last three years (September 2009 to September 2012) was collected. Length of stay in hospital, both in total and specifically due to their neurological symptoms was calculated along with the number of scans of the nervous system each patient had undergone in the last three years. Cost to the Primary Care Trust of each patient between April 2010 and August 2012 was calculated by a financial accountant at ASPH using the internal income software of the trust.

Results Patients with functional neurological symptoms experienced an average of five ward admissions, six A&E admissions and 24 days hospital stay between 2009 and 2012. On average, seventeen days of hospital stay were specifically due to neurological disease and patients had up to eleven scans within this period. The average cost of patients to ASPH was £13 288 in just two years and four months and the total cost of all nineteen patients was £262 975.

Conclusion Patients with functional neurological symptoms are associated with considerable hospital admissions, length of stays as well as high costs.

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