The societal costs of Anorexia nervosa in England: an investigation into the direct, indirect and intangible costs with particular regard to the role of outpatient services.

Bonin, Eva-Maria (2017) The societal costs of Anorexia nervosa in England: an investigation into the direct, indirect and intangible costs with particular regard to the role of outpatient services. PhD thesis, London School of Economics and Political Science.

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Abstract

Anorexia nervosa (AN) is a severe psychiatric illness affecting primarily adolescent females. Although prevalence rates are low, the associated morbidity, mortality and reduced quality of life result in a severe impact on the individual and thought to incur high societal costs. Combining new analyses of a variety of data sources with existing evidence, this thesis examines the societal costs of AN for England, including treatment costs and productivity impacts, and explores why costs may vary based on individual and service characteristics. An estimate of costs for 2010/11 is presented. The costs of treating AN and variations in costs associated with individual and service characteristics were studied using data from the MCTAAN trial, the Care Pathways Study, and three trials from the NIHR-funded Applied Research into Anorexia Nervosa and Not Otherwise Specified Eating Disorders (ARIADNE) programme. Education attainment and longer-term productivity were studied using data from the ALSPAC and BCS-70, respectively. Results were combined with existing evidence to estimate the societal costs of AN for England. The costs of treatment vary by service type and service characteristics. Individual treatment costs were positively associated with age and duration of illness, and vary by care pathway. Reporting lifetime incidence of AN was associated with a greater likelihood of being sick or disabled at age 30 (economic activity status). The prevalence of AN was estimated at approximately 12,000 cases, with around 6,000 Years of Potential Life Lost per year. The annual societal costs are estimated at between £80.8 million to £251.8 million. Policy recommendations include an emphasis on effective and early treatment, to avoid the need for (re-) hospitalisation – a strong predictor of negative patient outcome as well as treatment costs. There is a need to improve data quality in mental health services to build evaluation capacity

Item Type:	Thesis (PhD)
Additional Information:	© 2017 Eva-Maria Bonin
Library of Congress subject classification:	H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Sets:	Departments > Social Policy
Supervisor:	Fernández, José-Luis and Beecham, Jennifer
URI:	http://etheses.lse.ac.uk/id/eprint/3766

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