Cost-Effectiveness of Reduced Waiting Time for Head and Neck Cancer Patients due to a Lean Process Redesign

Autor: Bram Ramaekers, Madelon Pijls-Johannesma, Wim Marneffe, Pascale A.M. Simons, Dominique Vandijck, Frank J. P. Hoebers, Kenneth W. Kross
Přispěvatelé: Health Services Research, Radiotherapie, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R2 - Creating Value-Based Health Care, RS: GROW - Oncology, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, RS: GROW - R2 - Basic and Translational Cancer Biology
Rok vydání: 2015
Předmět:
Time Factors
economic evaluation
IMPACT
Cost effectiveness
Biopsy
Cost-Benefit Analysis
Multimodal Imaging
LOCAL-CONTROL
Workflow
head and neck
Health care
Stage (cooking)
Diagnostic Techniques and Procedures
health care economics and organizations
OUTCOMES
Cost–benefit analysis
Health Policy
Process Assessment
Health Care
cost-effectiveness analysis
Health Care Costs
Cost-effectiveness analysis
Markov Chains
Models
Economic
Treatment Outcome
Head and Neck Neoplasms
DELAY
SURVIVAL
Quality-Adjusted Life Years
RADIOTHERAPY
medicine.medical_specialty
Waiting Lists
CARCINOMA
Anesthesia
General
process redesign
waiting time
Time-to-Treatment
Predictive Value of Tests
medicine
Humans
Neoplasm Staging
business.industry
Head and neck cancer
Public Health
Environmental and Occupational Health
CARE
medicine.disease
Quality-adjusted life year
Surgery
Positron-Emission Tomography
Economic evaluation
Emergency medicine
Tomography
X-Ray Computed
business
Anesthesia
Local
Program Evaluation
Zdroj: Value in Health, 18(5), 587-596. Elsevier Science
ISSN: 1098-3015
DOI: 10.1016/j.jval.2015.04.003
Popis: Background: Compared with new technologies, the redesign of care processes is generally considered less attractive to improve patient outcomes. Nevertheless, it might result in better patient outcomes, without further increasing costs. Because early initiation of treatment is of vital importance for patients with head and neck cancer (HNC), these care processes were redesigned. Objectives: This study aimed to assess patient outcomes and cost-effectiveness of this redesign. Methods: An economic (Markov) model was constructed to evaluate the biopsy process of suspicious lesion under local instead of general anesthesia, and combining computed tomography and positron emission tomography for diagnostics and radiotherapy planning. Patients treated for HNC were included in the model stratified by disease location (larynx, oropharynx, hypopharynx, and oral cavity) and stage (I-II and 111-IV). Probabilistic sensitivity analyses were performed. Results: Waiting time before treatment start reduced from 5 to 22 days for the included patient groups, resulting in 0.13 to 0.66 additional quality-adjusted life-years. The new workflow was cost-effective for all the included patient groups, using a ceiling ratio of (sic)80,000 or (sic)20,000. For patients treated for tumors located at the larynx and oral cavity, the new workflow resulted in additional quality-adjusted life-years, and costs decreased compared with the regular workflow. The health care payer benefited (sic)14.1 million and (sic)91.5 million, respectively, when individual net monetary benefits were extrapolated to an organizational level and a national level. Conclusions: The redesigned care process reduced the waiting time for the treatment of patients with HNC and proved cost-effective. Because care improved, implementation on a wider scale should be considered. Copyright (C) 2015, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.
Databáze: OpenAIRE
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