title: Costs and benefits of a one stop clinic compared with a dedicated breast clinic: randomised controlled trial.
abstract: OBJECTIVE
  To determine the cost to the NHS and the impact on anxiety of a one stop clinic for assessing women with suspected breast cancer.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Women aged 35 or over referred with a breast lump.
  
  
  METHODS
  Teaching hospital, north west England.
  
  
  METHODS
  Women were randomly allocated to attend a one stop clinic or a dedicated breast clinic.
  
  
  METHODS
  Reduction in mean anxiety from baseline at 24 hours after the first visit and at 3 weeks and 3 months after diagnosis; mean cost per patient.
  
  
  RESULTS
  670 women were randomised. Compared with women who attended the dedicated clinic, patients attending the one stop clinic were less anxious 24 hours after the visit (adjusted mean change in state anxiety _5.7 (95% confidence interval _8.4 to _3.0)) but not at 3 weeks or 3 months after diagnosis. The additional cost to the NHS of a one stop attendance was pound 32 per woman; this was largely explained by greater cytopathological and radiological staff costs.
  
  
  CONCLUSIONS
  One stop clinics may not be justified in terms of a reduction in short term anxiety.
authors.affiliation: Centre for Cancer Epidemiology, University of Manchester, Manchester M20 4QL, UK. paola.dey@cce.man.ac.uk
authors.forename: Paola
authors.initials: P
authors.lastname: Dey
authors.forename: Nigel
authors.initials: N
authors.lastname: Bundred
authors.forename: Alan
authors.initials: A
authors.lastname: Gibbs
authors.forename: Penny
authors.initials: P
authors.lastname: Hopwood
authors.forename: Andrew
authors.initials: A
authors.lastname: Baildam
authors.forename: Caroline
authors.initials: C
authors.lastname: Boggis
authors.forename: Marilyn
authors.initials: M
authors.lastname: James
authors.forename: Fiona
authors.initials: F
authors.lastname: Knox
authors.forename: Vicki
authors.initials: V
authors.lastname: Leidecker
authors.forename: Ciarán
authors.initials: C
authors.lastname: Woodman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics*; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008327:Mammography / Q000191:economics; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics*; D017060:Patient Satisfaction; D013222:State Medicine / Q000191:economics; D013997:Time Factors; D016217:Ultrasonography, Mammary / Q000191:economics; D006113:United Kingdom