BACKGROUND AND AIM: Costs of follow-up strategies in patients after surgery for oesophageal cancer have not been evaluated. We therefore randomised 109 patients to standard outpatient clinic follow-up by a surgeon (n=55) or home visits by a specialist nurse (n=54) and compared costs between these two strategies. METHOD: Cost comparisons included comprehensive data on hospital costs, diagnostic interventions and extramural care. Detailed information on health care consumption was obtained from a case record form at 6 weeks, and 3, 6, 9 and 12 months after randomisation. RESULTS:Total medical costs were lower for nurse-led follow-up (euro 2592 versus euro 3798) than standard follow-up, although this difference was not statistically significant (p=0.11). This advantage in the nurse-led follow-up group was mainly due to lower costs for follow-up visits (euro 234 versus euro 503; p<0.001), and a trend towards lower costs for total intramural care (euro 1477 versus euro 2277; p=0.19). CONCLUSION: Nurse-led follow-up of patients after oesophageal cancer surgery is likely to be cost effective and may even generate cost savings. The results of this study further support a specific role of nurses in the medical care of patients with malignant diseases.
RCT Entities:
BACKGROUND AND AIM: Costs of follow-up strategies in patients after surgery for oesophageal cancer have not been evaluated. We therefore randomised 109 patients to standard outpatient clinic follow-up by a surgeon (n=55) or home visits by a specialist nurse (n=54) and compared costs between these two strategies. METHOD: Cost comparisons included comprehensive data on hospital costs, diagnostic interventions and extramural care. Detailed information on health care consumption was obtained from a case record form at 6 weeks, and 3, 6, 9 and 12 months after randomisation. RESULTS: Total medical costs were lower for nurse-led follow-up (euro 2592 versus euro 3798) than standard follow-up, although this difference was not statistically significant (p=0.11). This advantage in the nurse-led follow-up group was mainly due to lower costs for follow-up visits (euro 234 versus euro 503; p<0.001), and a trend towards lower costs for total intramural care (euro 1477 versus euro 2277; p=0.19). CONCLUSION: Nurse-led follow-up of patients after oesophageal cancer surgery is likely to be cost effective and may even generate cost savings. The results of this study further support a specific role of nurses in the medical care of patients with malignant diseases.
Authors: Beverley L Høeg; Pernille E Bidstrup; Randi V Karlsen; Anne Sofie Friberg; Vanna Albieri; Susanne O Dalton; Lena Saltbæk; Klaus Kaae Andersen; Trine Allerslev Horsboel; Christoffer Johansen Journal: Cochrane Database Syst Rev Date: 2019-11-21