1. MRF Meningitis Symposium Bristol
16 June 2011
Counting The Costs of MeningitisClaire Wright, Rebecca Wordsworth, Linda Glennie

2. Gold that buys health can never be ill spent ~Thomas Dekker, 1604
3. Methodology
Costing exercise
Illustrates the costs to the state of caring for survivors with severe after effects due to meningitis and septicaemia
We achieved this by:
Face to face and telephone interviews with MRF members
Detailed meetings and interviews with health care and educational professionals
Consultation with Casemix Service at NHS Information Centre and data standards team at NHS Connecting for Health
Project launch in spring 2011
4. Case Study
Meningitis
Septicaemia
Peter was hospitalised with Meningococcal septicaemia aged 12 months
Bilateral above knee leg amputations
Amputation of one arm below the elbow
Skin scarring over 60% of the body
Behavioural problems
Emma was hospitalised with meningitis aged 3
Insertion of shunt
Severe brain damage
Profound deafness
Severe hemiplegia
Loss of vision
Epilepsy
Incontinence
5. Medical costs
Meningitis
Septicaemia
Acute costs
26 days PICU, Shunt insertion operation and 155 days on rehabilitation ward
Outpatient appointments
Paediatricians, neurologists, neuro-surgeons, orthotist, opthalmologist, occupational therapists, physio-therapists, speech and language therapists, hydrotherapy
Epilepsy management
Cochlear implantation
Shunt revision surgery
Specialist equipment
Acute costs
31 days in PICU, amputation operations, dressing changes and debridement procedures, multiple skin graft operations, 155 days on paediatric ward
Outpatient appointments
Prosthetists, occupational therapists, physiotherapists, plastic surgeon, orthopaedic surgeon, paediatricians, CAMHS
Behavioural management
Prosthetic provision
Corrective surgery
Specialist equipment
951,922
612,087
6. Educational costs
Meningitis
Septicaemia
Peter has SEN statement
School adaptations/equipment
Learning support assistant
Nursery and school (until 13)
Help with physio at school and personal assistance
Free transport to and from school
Emma has SEN statement
Issue and annual review multiprofessional input
Special educational needs nursery age 4
Maintained special needs school age 5 to 19
Free transport to and from school
238,245
206,769
7. Social costs
Meningitis
Septicaemia
Direct
Disabled facilities grant, government specialised vehicle fund, direct payments for home help, disabled students allowance
Indirect
Tax revenue from one parent becoming carer and Peters restricted job opportunities
Benefit payments
Carers allowance, extra child tax credits, DLA, working tax credits, housing benefit, council tax benefit, pension credit
Direct
Disabled facilities grant, government specialised vehicle fund, social care assessment and review, direct payments for home help, short break provision, residential home from age 40
Indirect
Tax revenue from one parent becoming carer and Emmas potential job
Benefit payments
Carers allowance, extra child tax credits, DLA
2,657,332
1,674,683
8. Other considerations
Day to day costs to the family are three times more compared to a family with a non-disabled child
Minimum budget to bring up disabled child 7,355 per year
Minumum budget to bring up non-disabled child 2,100 per year (Joseph Rowntree Foundation, 1998)
Families are 4 times more likely to be living in poverty
84% of mothers of disabled children do not work compared to 39% of mothers of non disabled children (New Philanthropy Capital, 2007)
Impact on third parties
Siblings of disabled children are more likely to experience behavioural and emotional problems (New Phil. Cap., 2007)
Depression and anxiety more common among other family members (New Phil. Cap., 2007)
9. Cost summary
10. The bigger picture
MRF estimate around 3,300 people get bacterial meningitis and septicaemia in the UK and Republic of Ireland every year
25% of survivors live with life altering after effects (Grimwood et al. Pediatrics 1995)
Sequelae
3% growth plate damage (NICE Clinical Guideline 2010)
3% amputations (NICE Clinical Guideline 2010)
13% skin damage (NICE Clinical Guideline 2010)
10.5% (4-15% range) hearing loss (Barraff et al, Pediatr. Inf. dis. J., 1993)
14% neurological deficits (Chandran et al, Pediatr. In.f dis. J., 2010)
Subtle after effects
Healthy survivors of meningitis pass significantly fewer GCSEs than controls (de Louvois et al, Arch. Dis. Child., 2007)
Educational support has been shown to be lacking.Is this cost passed on to society via reduced potential?
11. Sign the Petition
Meningitis Research Foundation calls for:

Government to pursue the widest and earliest possible implementation of effective vaccines against all strains of meningitis and septicaemia across the UK. There may soon be an opportunity to prevent MenB (meningococcal group b disease) the leading cause of life-threatening meningitis and septicaemia in UK children.
Government to change its criteria for assessing the value of vaccination for meningitis and septicaemia to include full medical costs, plus social and educational costs of the disease.
12. Prevention is better than cure