The core procedures of brachytherapy

Buil, J.H. and Haalboom, M.T. and Issa, R. and Trentelman, E. (2012) The core procedures of brachytherapy.

[img]
Preview
PDF
1MB
Abstract:Introduction Rising healthcare costs and a new reimbursement system for hospital care in the Netherlands have increased the focus on healthcare costs. In order to make informed decisions regarding allocations of scares resources to cancer treatments such as brachytherapy, an important first step is the identification of the core procedures of brachytherapy and an inventory of the resources associated with this treatment. The research question of this prospective multicenter study therefore is: how much time, attendance of medical staff and resources are needed for conducting the core procedures of LDR BT and HDR BT in patients with prostate cancer (and in addition patients with gynecological cancer)? This study has focused upon the prostate as body site, because prostate cancer is the most common cancer in men and can be treated with both forms of brachytherapy. And since the opportunity has arisen and HDR BT is a standard procedure for gynecological cancer, gynecological cancer has also been included. Methods The main research question has been addressed by performing a prospective multicenter study in which qualitative and quantitative methods have been combined. Two private radiotherapy institutes, RISO in Deventer and ARTI in Arnhem, and the University Medical Center in Utrecht participated in the study, which has been carried out in May and June 2012. The core procedures associated with LDR BT en HDR BT in patients with prostate cancer and HDR BT in patients with gynecological cancer have been identified in a first round of inventory interviews. During follow-up interviews the duration of these core procedures, the time spent per medical staff member, and the resources needed have been identified. Finally, during observations, additional data about the duration of the core procedures and the time spent by the medical staff members has been derived. Results Three models, which present the core procedures of LDR BT in prostate cancer, HDR BT in prostate cancer and HDR BT in gynecological cancer, have been developed (Figure 2, 4 and 6). The treatment processes of LDR BT and HDR BT in prostate cancer and HDR BT in gynecological cancer consist of 15, 16 and 18 core procedures respectively. According to the follow-up interviews, the total duration of LDR BT is not very different with HDR BT for prostate cancer (a median of 558 versus 579 minutes, respectively). The results on the time spent per medical staff member and the resources needed in conducting these core procedures are shown in Table 2 to 11. Conclusion and Discussion Regarding the core procedures of LDR BT and HDR BT, it can be concluded that despite the difference in the number of core procedures and the differences on a more detailed level, LDR BT and HDR BT also have many similarities on a more general level. Based upon the information from the follow-up interviews it can be concluded that the core procedures that take place outside the operation room are the most 5 time consuming in LDR BT, while the core procedures that take place inside the operation room are the most time consuming in HDR BT in prostate cancer. When comparing HDR BT in gynecological cancer to HDR BT in prostate cancer it appears that the total duration of all the core procedures in HDR BT in gynecological cancer is much higher than in HDR BT in prostate cancer. The total times of LDR BT and HDR BT in prostate cancer are quite comparable. Furthermore, the resources used for HDR BT and LDR BT appear to be mainly similar to each other. Recommendations on the favorability of any of the treatment modalities can be made based on researches that determine the costs of the several procedures and staff. The models for the core procedures and the inventory of the duration of core procedures, attendance of medical staff involved and resources needed as presented in this research can be used as a guideline for this cost estimation and also are of particular importance for compiling the content of the DTC‟s (Diagnosis Treatment Combinations) that are applicable for brachytherapy. The most important weakness of the current study is the fact that the results are based on interviews with medical professionals from only three different radiotherapy centers and interviews were not held with all involved staff.
Item Type:Essay (Bachelor)
Clients:
Nucletron
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences BSc (56553)
Link to this item:http://purl.utwente.nl/essays/61724
Export this item as:BibTeX
EndNote
HTML Citation
Reference Manager

 

Repository Staff Only: item control page