title: Fast-track access to urologic care for patients with macroscopic haematuria is efficient and cost-effective: results from a prospective intervention study.
abstract: The delay between onset of macroscopic haematuria and diagnosis of bladder cancer is often long.
  
  
  
  We evaluated timely diagnosis and health-care costs for patients with macroscopic haematuria given fast-track access to diagnostics. During a 15-month period, a telephone hotline for fast-track diagnostics was provided in nine Swedish municipalities for patients aged ⩾50 years with macroscopic haematuria. The control group comprised 101 patients diagnosed with bladder cancer in the same catchment area with macroscopic haematuria who underwent regular diagnostic process.
  
  
  
  In all 275 patients who called 'the Red Phone' hotline were investigated, and 47 of them (17%) were diagnosed with cancer and 36 of those had bladder cancer. Median time from patient-reported haematuria to diagnosis was 29 (interquartile range (IQR) 14-104) days and 50 (IQR 27-165) days in the intervention and the control group, respectively (P=0.03). The median health-care costs were lower in the intervention group (655 (IQR 655-655) EUR) than in the control group (767 (IQR 490-1096) EUR) (P=0.002).
  
  
  
  Direct access to urologic expertise and fast-track diagnostics is motivated for patients with macroscopic haematuria to reduce diagnostic intervals and lower health-care expenditures.
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.|Department of Translational Medicine, Lund University, Malmö, Sweden.
authors: Fredrik
authors: F
authors: Liedberg
authors: The Swedish Institute for Health Economics, Lund University, Lund, Sweden.
authors: Ulf
authors: U
authors: Gerdtham
authors: The Swedish Institute for Health Economics, Lund University, Lund, Sweden.
authors: Katarina
authors: K
authors: Gralén
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors: Sigurdur
authors: S
authors: Gudjonsson
authors: Regional Cancer Centre South, Region Skåne, Lund, Sweden.
authors: Staffan
authors: S
authors: Jahnson
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors: Irene
authors: I
authors: Johansson
authors: Regional Cancer Centre South, Region Skåne, Lund, Sweden.|Divisions of Cancer Epidemiology and Oncology-Pathology, Institute of Clinical Sciences, Lund, Sweden.
authors: Oskar
authors: O
authors: Hagberg
authors: Lundbergsgatan Primary Healthcare Centre, Malmö, Sweden.
authors: Staffan
authors: S
authors: Larsson
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors: Anna-Karin
authors: AK
authors: Lind
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors: Annica
authors: A
authors: Löfgren
authors: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors: Jenny
authors: J
authors: Wanegård
authors: Regional Cancer Centre South, Region Skåne, Lund, Sweden.|Divisions of Cancer Epidemiology and Oncology-Pathology, Institute of Clinical Sciences, Lund, Sweden.
authors: Hanna
authors: H
authors: Åberg
authors: Regional Cancer Centre South, Region Skåne, Lund, Sweden.|Divisions of Cancer Epidemiology and Oncology-Pathology, Institute of Clinical Sciences, Lund, Sweden.|Clinical Research Centre, Hvidovre University Hospital, Copenhagen University, Copenhagen, Denmark.
authors: Mef
authors: M
authors: Nilbert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003362:Cost-Benefit Analysis; D003404:Creatinine / Q000097:blood; D003558:Cystoscopy; D057210:Delayed Diagnosis / Q000191:economics; D055088:Early Detection of Cancer / Q000191:economics; D061345:Early Medical Intervention / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006417:Hematuria / Q000175:diagnosis* / Q000191:economics / Q000209:etiology / Q000451:nursing; D015277:Hotlines; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation; D013548:Sweden / Q000453:epidemiology; D061665:Time-to-Treatment; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D014572:Urology / Q000458:organization & administration*
chemical_list: D003404:Creatinine