[Evaluation of the efficacy and efficiency of a multidisciplinary unit for the treatment of patients with colorectal cancer].
BACKGROUND
Because of the increased complexity of the diagnostic-therapeutic approach to colorectal cancer (CRC), these patients should be managed in specialized multidisciplinary units. The aim of this study was to evaluate the efficacy and efficiency of a CRC unit (CRCU) in the diagnostic-therapeutic management of these patients.


METHODS
Two groups of 50 patients with colon cancer treated in our center before and after the implementation of the CRCU were selected. Fulfillment with the protocol in terms of tumoral staging, surgical and adjuvant treatment, follow-up, interval until treatment, hospital stay, morbidity and early mortality, and the overall duration of the diagnostic-therapeutic process was analyzed. In addition, clinical workload was evaluated and a cost-minimization analysis was performed.


RESULTS
The CRCU reduced the interval until surgery (20.3 12.0 vs 28.0 20.4 days; p = 0.05), hospital stay (9.8 7.7 vs 14.5 9.3 days: p = 0.01), the time to the start of adjuvant treatment (29.4 10.2 vs 39.7 19.8 days; p = 0.03) and the overall duration of the process (60.4 23,8 vs 82.1 46.1 days; p = 0.05), representing a saving of 978.85 E per patient. This improvement took place despite an increase in clinical workload (24% in 5 years in relation to the number of admissions) and had no effect on morbidity (26 vs 24%; NS) or immediate mortality (6 vs 4%; NS).


CONCLUSIONS
Specialized multidisciplinary units increase the efficacy and efficiency of the management of patients with CRC.
Soriano
A
A
Servicios de Gastroenterología. Institut de Malalties Digestives. Hospital Clinic. IDIBAPS. Universitat de Barcelona. Spain.
Castells
A
A
Lacy
A M
AM
Ayuso
C
C
Ayuso
J R
JR
Conill
C
C
Delgado
S
S
Fuster
J
J
García-Valdecasas
J C
JC
Ginès
A
A
Martín
M
M
Maurel
J
J
Miquel
R
R
Mollà
M
M
Vilana
R
R
Castellví-Bel
S
S
Elizalde
J I
JI
Piñol
V
V
Pellisé
M
M
Biete
A
A
Gascón
P
P
Piqué
J M
JM
D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics / Q000628:therapy*; D019033:Delivery of Health Care, Integrated; D017598:Efficiency, Organizational; D005260:Female; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics; D006801:Humans; D007400:Interprofessional Relations; D007902:Length of Stay / Q000191:economics; D008297:Male; D015397:Program Evaluation; D016896:Treatment Outcome