Cost-effectiveness of a short stay admission programme for breast cancer surgery

Authors

  • Mascha de Kok Department of Surgery, Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands
  • Carmen D. Dirksen Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands
  • Alfons G. Kessels Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands
  • Trudy van der Weijden Department of General Practice/ School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands
  • Cornelis J van de Velde Department of Surgery, Leiden University Medical Center, PO Box 9600 Leiden, the Netherlands
  • Jan A. Roukema Breast Unit, St. Elisabeth Hospital, PO Box 90151 Tilburg, the Netherlands
  • Antoine V. Bell Department of Surgery, Laurentius Hospital, PO Box 920 Roermond, the Netherlands
  • Fred W. van der Ent Department of Surgery, Orbis Medical Center, PO Box 5500 Sittard, the Netherlands
  • Maarten F. von Meyenfeldt Department of Surgery, Maastricht University Medical Center, PO Box 5800 Maastricht, the Netherlands

DOI:

https://doi.org/10.3109/02841861003610192

Abstract

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 €955,- (95% CI € - 2104,- to €157,-) for patients in SSP (n=127) compared with CAU (n=135). Mean healthcare costs differed €883,- (95% CI € - 1560,- to €870,-) 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.

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Published

2010-01-01

How to Cite

de Kok, M., Dirksen, C. D., Kessels, A. G., van der Weijden, T., van de Velde, C. J., Roukema, J. A., … von Meyenfeldt, M. F. (2010). Cost-effectiveness of a short stay admission programme for breast cancer surgery. Acta Oncologica, 49(3), 338–346. https://doi.org/10.3109/02841861003610192

Issue

Vol. 49 No. 3 (2010): Acta Oncologica

Section

Articles