{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T08:17:39Z","timestamp":1792743459660,"version":"4.5.0"},"reference-count":14,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2020,10,6]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"\n Objective<\/jats:title>\n Iron deficiency anaemia (IDA) occurs in 2%\u20135% of men and postmenopausal women in the developed world and, if left untreated, can significantly impair quality of life or decompensate chronic illnesses. Approximately 10% of men and postmenopausal women with IDA have underlying gastrointestinal malignancy. This study identifies trends in the management of IDA in secondary care in England.<\/jats:p>\n <\/jats:sec>\n \n Design\/method<\/jats:title>\n The Hospital Episode Statistics database was used to analyse IDA-related hospital and outpatient admissions (elective and non-elective) in National Health Service England between April 2012 and March 2018. Outcome measures included rates of readmission, length of stay (LOS) and cost per admission.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Between 2012\/2013 and 2017\/2018, there was a 72% increase in hospital admissions for patients with a primary diagnosis of IDA and a 68% increase in hospital spells, with the number of cases being managed non-electively increasing by 58%. Non-electively managed patients had a longer LOS (3.10 vs 0.04 days, respectively) and increased rate of readmissions within 30 days (24.1% vs 6.6%) versus patients managed electively. Average day-case cost was \u00a3449 versus \u00a31676 for non-elective admission. Across the 195 clinical commissioning groups (CCGs) in England, non-elective spells per 100\u2009000 population demonstrated extensive and widening variability, ranging from 18 to 118 in 2017\/2018 compared with 11\u201355 in 2012\/2013.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The current analysis highlights several opportunities to improve patient outcomes and reduce costs. There is an opportunity to improve day-case services by looking at the difference between CCGs and the variability in care and to reduce the number of non-elective admissions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/flgastro-2020-101506","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T17:23:26Z","timestamp":1603733006000},"page":"363-369","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Management of iron deficiency anaemia in secondary care across England between 2012 and 2018: a real-world analysis of Hospital Episode Statistics"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8782-0292","authenticated-orcid":false,"given":"Matthew James","family":"Brookes","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK"},{"name":"Research Institue, University of Wolverhampton Faculty of Science and Engineering, Wolverhampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2087-9310","authenticated-orcid":false,"given":"Angela","family":"Farr","sequence":"additional","affiliation":[{"name":"College of Human and Health Sciences, Swansea University, Swansea, West Glamorgan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceri J","family":"Phillips","sequence":"additional","affiliation":[{"name":"College of Human and Health Sciences, Swansea University, Swansea, West Glamorgan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel John","family":"Trudgill","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"key":"2025090707593903000_12.5.363.1","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"Abbaspour","year":"2014","journal-title":"J Res Med Sci"},{"key":"2025090707593903000_12.5.363.2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228874"},{"key":"2025090707593903000_12.5.363.3","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1002\/ajh.24820","article-title":"Iron deficiency across chronic inflammatory conditions: international expert opinion on definition, diagnosis, and management","volume":"92","author":"Cappellini","year":"2017","journal-title":"Am J Hematol"},{"key":"2025090707593903000_12.5.363.4","unstructured":"Data on file: Hospital episode statistic data 2012-2018 (accessed under a commercial re-use licence via Harvey Walsh LTD.)."},{"key":"2025090707593903000_12.5.363.5","unstructured":"Department of Health . The NHS outcomes framework 2015\/2016. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/385749\/NHS_Outcomes_Framework.pdf [Accessed Jan 2020]."},{"key":"2025090707593903000_12.5.363.6","doi-asserted-by":"publisher","DOI":"10.1136\/gut.34.8.1102"},{"key":"2025090707593903000_12.5.363.7","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2014-100435"},{"key":"2025090707593903000_12.5.363.8","unstructured":"NHS Digital . Hospital episode statistics (Hes). Available: https:\/\/digital.nhs.uk\/data-and-information\/data-tools-and-services\/data-services\/hospital-episode-statistics [Accessed Jan 2020]."},{"key":"2025090707593903000_12.5.363.9","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jemermed.2019.08.052","article-title":"Identification and management of iron deficiency anemia in the emergency department","volume":"57","author":"Boone","year":"2019","journal-title":"J Emerg Med"},{"key":"2025090707593903000_12.5.363.10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1017\/cem.2016.388","article-title":"Iron deficiency anemia in the emergency department: over-utilization of red blood cell transfusion and infrequent use of iron supplementation","volume":"19","author":"Spradbrow","year":"2017","journal-title":"CJEM"},{"key":"2025090707593903000_12.5.363.11","unstructured":"Nuffield Trust . The health Foundation. QualityWatch: Focus on preventable admissions, 2013. https:\/\/www.health.org.uk\/publications\/qualitywatch-focus-on-preventable-admissions"},{"key":"2025090707593903000_12.5.363.12","unstructured":"NHS England and NHS Improvement . Refreshing NHS plans for 2018\/2019. Available: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2018\/02\/planning-guidance-18-19.pdf [Accessed Jan 2020]."},{"key":"2025090707593903000_12.5.363.13","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000314"},{"key":"2025090707593903000_12.5.363.14","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdv041"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2020-101506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T14:59:49Z","timestamp":1757257189000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2020-101506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,26]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,8,6]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/flgastro-2020-101506"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2020-101506","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,26]]}}}