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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY P.V.F. LE CLAIRE OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 23rd FEBRUARY 2010
Question
"What is the cost to the Health Service in Jersey from respiratory illness per annum?
What are the main causes of respiratory illness and can these be given on a percentage basis? What are the interventions that are given in Jersey to alleviate these illnesses?
What are costs and manpower implications in doing so?"
Answer Increasing costs
It is not possible to calculate with any degree of meaningful accuracy the cost of respiratory illness to Health and Social Services. It does however represent a significant and growing cost.
At present respiratory diagnoses represent 4 out of the top 10 reasons for acute emergency admissions in Jersey, with the rate of repeat emergency admissions rising by 10% in the past 5 years. Outpatient respiratory referrals have also increased significantly.
Chronic obstructive pulmonary disease (COPD) alone accounts for 1,000 admissions each year, with an average length of stay of between 5 and 7 days (ie. 5,000 - 7,000 bed days). Given that COPD is prevalent in more the 10% of people aged 70 or over, the costs associated with managing and treating this condition will inevitably increase as our population ages.
Causes of respiratory illness
There are many causes of respiratory illness, of which the primary one are listed below. Many cases have multiple, as opposed to single causes and it is not possible to indicate in percentage terms the number of cases attributable to each cause. Smoking and passive smoking, are obviously major factors and initiatives which support smoking cessation will bring major health benefits, although it should be noted that recent studies indicate that up to one third of patients with COPD are non-smokers. Therefore even if our aging population did not smoke COPD would still represent a significant health challenge.
Primary causes include:
• viral lung infections in childhood or inadequate lung development in childhood
• smoking or passive smoking
• hereditary factors
• air pollution
• nutrient or social deprivation (poor diet, poor housing)
• occupational or accidental exposure to materials such as dust, asbestos fibres and other irritant particles
Interventions
The core components of the local service include:
Chronic Outpatient/Inpatient care obstructive Rehabilitation pulmonary disease Oxygen therapy
Nebuliser service
Lung volume reduction surgery/Transplantation
Palliation
Prevention
Non invasive ventilation
Static/dynamic respiratory function tests
Lung Cancer Rapid assessment (lung function, CT scans and Bronchoscopy). Treatment will
be dependant on the assessment process but could include referral and surgery at Southampton General Hospital
(approximately 10% of cases). Other treatments include:
• Radiotherapy
• Chemotherapy
• Palliation
Asthma Outpatient/Inpatient
Occupational asthma
Assessment and regular review of more severe cases
TB Small numbers
Intensive workload – frequent review/contact tracing
Other diseases Obstructive sleep apnoea
Allergic rhinitis
Chronic cough
Interstitial lung disease
Cost and manpower implications
As indicated above it is not possible to provide a breakdown of all the costs, which will include both costs incurred during Jersey based treatment and referrals to the UK.