Cost-effectiveness analysis of the oncology patient navigation program at a referral cancer center for colorectal tumor treatment
Objective: To evaluate the financial impact and effectiveness of a navigation program in patients with colorectal tumors undergoing videolaryngoscopic rectosigmoidectomy. Material and Methods: Retrospective, case-control type study from May 2019 to December 2020 with patients 18 years-old o...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2023-04-01
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| Series: | Brazilian Journal of Oncology |
| Subjects: | |
| Online Access: | https://www.brazilianjournalofoncology.com.br/details/241/en-US/cost-effectiveness-analysis-of-the-oncology-patient-navigation-program-at-a-referral-cancer-center-for-colorectal-tumor-treatment |
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| Summary: | Objective: To evaluate the financial impact and effectiveness of a navigation program in patients with colorectal tumors undergoing videolaryngoscopic rectosigmoidectomy.
Material and Methods: Retrospective, case-control type study from May 2019 to December 2020 with patients 18 years-old or older; with sigmoid, retosigmoid junction or upper rectal tumors, submitted to elective laparoscopic sigmoidectomy or high anterior resection with high colorectal anastomosis. The main endpoints were: costs during the patients pathway; interval between first appointment and surgery; use of unit of intensive care (ICU) or not; use of emergency room after discharge. Categorical variables were compared by chi-square test, Fisher’s exact test, and Mann-Whitney.
Results: 71 patients, with 49 (69%) not navigated and 22 (31%) navigated. In the diagnostic stage, navigated patients were more referred to physical therapy (81.8% vs. 46.9%, p=0.013) and nutrition specialist (81.8% vs. 57, p=0.081) and performed more diagnostic tests according to the institutional protocol (86.4% vs. 75.5%), contributing with an average revenue per patient 90% higher, p=0.01). The mean time from first visit to surgery, although shorter, had no statistical difference (26 vs. 28 days, p=0.794), as well as the length of stay (5.3 vs. 8.2, p=0.082) and visits to the emergency room within 30 days after discharge (18% vs. 22%, p=1.0). However, the percentage of patients in ICU was 73.8% lower in navigated patients (34.7% vs. 9.1%, p=0.05). 4.5% of navigated patients were cost-outliers vs. 36.5% of non-navigated patients, p=0.05. This resulted in a 18.5% lower cost of surgery and a 16% cheaper journey compared to the non-navigated patients.
Conclusion: Navigated patients on oncology treatment have lower costs along the journey and better outcomes with shorter ICU stays, as well as more compliant with institutional protocols. |
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| ISSN: | 2526-8732 |