Cost comparison study of two different follow-up protocols after surgery for oesophageal cancer.
OBJECTIVE
Costs of follow-up strategies in patients after surgery for oesophageal cancer have not been evaluated. We therefore randomised 109 patients to standard outpatient clinic follow-up by a surgeon (n=55) or home visits by a specialist nurse (n=54) and compared costs between these two strategies.


METHODS
Cost comparisons included comprehensive data on hospital costs, diagnostic interventions and extramural care. Detailed information on health care consumption was obtained from a case record form at 6 weeks, and 3, 6, 9 and 12 months after randomisation.


RESULTS
Total medical costs were lower for nurse-led follow-up (euro 2592 versus euro 3798) than standard follow-up, although this difference was not statistically significant (p=0.11). This advantage in the nurse-led follow-up group was mainly due to lower costs for follow-up visits (euro 234 versus euro 503; p<0.001), and a trend towards lower costs for total intramural care (euro 1477 versus euro 2277; p=0.19).


CONCLUSIONS
Nurse-led follow-up of patients after oesophageal cancer surgery is likely to be cost effective and may even generate cost savings. The results of this study further support a specific role of nurses in the medical care of patients with malignant diseases.
Polinder
Suzanne
S
Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Verschuur
Els M L
EM
Siersema
Peter D
PD
Kuipers
Ernst J
EJ
Steyerberg
Ewout W
EW
D003362:Cost-Benefit Analysis; D004938:Esophageal Neoplasms / Q000191:economics* / Q000451:nursing / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics*; D011788:Quality of Life