Costs and benefits of a one stop clinic compared with a dedicated breast clinic: randomised controlled trial.
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.
Dey
Paola
P
Centre for Cancer Epidemiology, University of Manchester, Manchester M20 4QL, UK. paola.dey@cce.man.ac.uk
Bundred
Nigel
N
Gibbs
Alan
A
Hopwood
Penny
P
Baildam
Andrew
A
Boggis
Caroline
C
James
Marilyn
M
Knox
Fiona
F
Leidecker
Vicki
V
Woodman
Ciarán
C
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