Document Detail


Cost-effectiveness of a short stay admission programme for breast cancer surgery.
MedLine Citation:
PMID:  20397768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Short stay (admission, surgery, and discharge the same day or within 24 hours) following breast cancer surgery is part of an established care protocol but as yet not well implemented in Europe. Alongside a before-after multi-centre implementation study, an economic evaluation was performed exploring the cost-effectiveness of a short stay programme (SSP) versus care as usual (CAU). MATERIAL AND METHODS: In the implementation study, 324 patients were included. In the economic evaluation a societal perspective was applied with a six week time horizon. Cost data were obtained from Case Record Forms and cost diaries. Effectiveness was assessed by calculating Quality Adjusted Life Years (QALYs), using the EuroQol-5D. Cost-effectiveness was expressed as the incremental costs per QALY. RESULTS: Mean societal costs decreased by euro955,- (95% CI euro - 2104,- to euro157,-) for patients in SSP (n=127) compared with CAU (n=135). Mean healthcare costs differed euro883,- (95% CI euro - 1560,- to euro870,-) in favour of SSP. The incremental cost-effectiveness ratio could not be calculated due to similar effectiveness for both groups, i.e. the difference in QALYs was zero. The cost-effectiveness acceptability curves showed that the probability that SSP was more cost-effective than CAU was over 90% in the base-case analysis. DISCUSSION: A short stay programme as implemented is cost-effective compared with care as usual. In achieving good and more efficient quality of care, larger scale implementation is warranted.
Authors:
Mascha de Kok; Carmen D Dirksen; Alfons G Kessels; Trudy van der Weijden; Cornelis J van de Velde; Jan A Roukema; Antoine V Bell; Fred W van der Ent; Maarten F von Meyenfeldt
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta oncologica (Stockholm, Sweden)     Volume:  49     ISSN:  1651-226X     ISO Abbreviation:  Acta Oncol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709065     Medline TA:  Acta Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  338-46     Citation Subset:  IM    
Affiliation:
Department of Surgery, Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands. m.dekok@ah.unimaas.nl
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Breast Neoplasms / economics*,  rehabilitation,  surgery*
Cost-Benefit Analysis
Educational Status
Employment
Female
Health Care Costs / trends*
Home Nursing / economics
Hospital Costs / trends
Humans
Length of Stay / economics*
Marital Status
Middle Aged
Netherlands
Program Evaluation
Quality-Adjusted Life Years
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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