title: Cost comparison study of two different follow-up protocols after surgery for oesophageal cancer.
abstract: 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.
authors.affiliation: Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Polinder
authors.forename: Els M L
authors.initials: EM
authors.lastname: Verschuur
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Ewout W
authors.initials: EW
authors.lastname: Steyerberg
mesh_terms: 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