title: [Evaluation of the efficacy and efficiency of a multidisciplinary unit for the treatment of patients with colorectal cancer].
abstract: 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.
authors.affiliation: Servicios de Gastroenterología. Institut de Malalties Digestives. Hospital Clinic. IDIBAPS. Universitat de Barcelona. Spain.
authors.forename: A
authors.initials: A
authors.lastname: Soriano
authors.forename: A
authors.initials: A
authors.lastname: Castells
authors.forename: A M
authors.initials: AM
authors.lastname: Lacy
authors.forename: C
authors.initials: C
authors.lastname: Ayuso
authors.forename: J R
authors.initials: JR
authors.lastname: Ayuso
authors.forename: C
authors.initials: C
authors.lastname: Conill
authors.forename: S
authors.initials: S
authors.lastname: Delgado
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authors.initials: J
authors.lastname: Fuster
authors.forename: J C
authors.initials: JC
authors.lastname: García-Valdecasas
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authors.initials: A
authors.lastname: Ginès
authors.forename: M
authors.initials: M
authors.lastname: Martín
authors.forename: J
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authors.lastname: Maurel
authors.forename: R
authors.initials: R
authors.lastname: Miquel
authors.forename: M
authors.initials: M
authors.lastname: Mollà
authors.forename: R
authors.initials: R
authors.lastname: Vilana
authors.forename: S
authors.initials: S
authors.lastname: Castellví-Bel
authors.forename: J I
authors.initials: JI
authors.lastname: Elizalde
authors.forename: V
authors.initials: V
authors.lastname: Piñol
authors.forename: M
authors.initials: M
authors.lastname: Pellisé
authors.forename: A
authors.initials: A
authors.lastname: Biete
authors.forename: P
authors.initials: P
authors.lastname: Gascón
authors.forename: J M
authors.initials: JM
authors.lastname: Piqué
mesh_terms: 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