Patient Level Activity and Costing, 2021-22

A total cost of £4.9 billion was reported for EC activity. This is summarised by the sex and age value of the HES linked attendance. £962.5 million (19.6%) of the total cost of EC activity did not link to a HES attendance and is not included in this analysis. Sex or age was unknown or not specified for the linked HES attendance for £40.2 million (0.8%) of reported cost.

The distribution of total cost by age is broadly similar for each sex, with higher costs for males than females in the under 15 age groups, and higher costs for females than males in the age groups between 15 and 39 years, and above 75 years.

For ages 5 and over, the ratio of total cost to count of attendances tends to increase with patient age, indicating that the average cost of attendance increases with patient age.

A total cost of £37.3 billion was reported for APC activity. For the 2021-22 PLICS data collection, APC activity includes community inpatient episodes. Out of 17.1 million APC episodes, 104,631 (0.6%) are community episodes which account for £545.6 million (1.5%) of the total cost.

APC activity is summarised by the sex, age and diagnosis value of the HES linked episode. £2.6 billion (7.1%) of the total cost of APC activity did not link to a HES episode and incomplete episodes that linked to a finished HES episode accounted for £44.7 million (0.1%) of the total cost. These costs are not included in the analysis of sex, age, or diagnosis. Sex or age was unknown or not specified on the linked HES episode for £11.2 million (less than 0.1%) of reported cost.

The higher total cost and count of episodes for females in the age groups between 15 and 49 compared to males are likely to reflect maternity related admissions.

Total cost and count of APC activities can be analysed by ICD-10 chapter of primary diagnosis for the linked HES finished consultant episode.

The variation between total cost of episodes by diagnosis chapter is influenced by both the frequency of episodes in each diagnosis chapter and the diagnosis chapter itself.  The diagnosis group 'Diseases of the circulatory system’ had the highest recorded total cost however ‘Diseases of the digestive system’ had the highest activity count.

A total cost of £14 billion was reported for OP activity. This is summarised by the sex and age value of the HES linked appointment. £1.4 billion (10.4%) of the total cost of OP activity did not link to a HES appointment and is not included in this analysis. Sex or age was unknown or not specified on the linked HES appointment for £2.5 million (less than 0.1%) of reported cost.

The total cost and count of appointments are markedly higher for females in the age groups from 15 to 64 compared to males in the same age groups. Part of this difference is likely to reflect maternity related appointments.

For costing purposes some activity is ‘unbundled’ and the costs are identified separately from the costs for the ‘core’ activity.  Details of submitted ‘unbundled’ PLICS activity is reported in the sections below.

SWC includes unbundled costs relating to admitted patient care, specifically critical care.  Critical care can be split into three component types: adult, neonatal and paediatric. Providers for any of these three types of critical care activity were mandated to submit to the 2021-22 PLICS data collection.

SWC costs totalled £4.2 billion, of which 68.1% were related to adult admitted patient critical care in the PLICS data collection, totalling £2.9 billion.

SI captures the cost of elements additional to the package of care and reported separately from it. This includes high-cost drugs and high-cost blood products, high-cost devices, and unbundled outpatient diagnostic imaging with a total cost of £3.4 billion in the PLICS data collection for 2021-22.

SI activity counts are not reported as recording of activity may not be consistent across providers.

For the 2021-22 PLICS data collection, activity covering wheelchair equipment was introduced to and mandated in the SI feed. This is not reflected in the chart above but is included in overall figures and the csv output.