University of Twente Student Theses
Efficacy, cost-effectiveness, and budget impact of a personalized discharge letter to basal cell carcinoma patients to reduce low-value follow-up care
Vliet, E.D. van (2020) Efficacy, cost-effectiveness, and budget impact of a personalized discharge letter to basal cell carcinoma patients to reduce low-value follow-up care.
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| Abstract: | Importance The incidence of keratinocyte carcinomas (KC) is high, rapidly growing and shows no signs of stabilizing. Approximately 80% of these diagnoses consist of basal cell carcinomas (BCC). Of these BCCs, 50% is considered to be low risk. The high number of patients makes KCs the fifth most expensive type of cancer in the Netherlands. Currently 83% of the low-risk BCC patients receive more follow-up care than the Dutch BCC guideline recommends, which is limited to one visit post-treatment. More efficient management could reduce unnecessary follow-up care and lower the costs. Objective To study the efficacy, the cost-effectiveness, and the budget impact of a personalized discharge letter on the number of follow-up visits for patients following a low-risk basal cell carcinoma compared with usual care. Design Model-based cost-effectiveness analysis using individual patient data gathered via surveys. Setting Multicenter; one academic hospital, three general hospitals, and two independent sector treatment centers. Participants The study included 473 first-time BCC patients. Intervention and control The intervention consisted of a personalized discharge letter on top of one follow-up visit, which is the care as usual in the Netherlands. The control group received only care as usual. Main outcome measures The outcome measures were number of follow-up visits, costs and quality adjusted life years (QALY) per patient, incremental cost-effectiveness ratio and the budget impact. Results A personalized discharge letter lowered the number of follow-up visits by 13% in one year. The incremental costs after five years were -€26.04 per patient and -€26.07 after ten years. The QALYs were 4.126 after five years and 7.262 after ten. They were nearly equal in both groups. Using a five-year time horizon, the incremental cost-effectiveness ratio was expected to be -€10,045,-. The budget impact was -€2,9 million after five years. Conclusion and relevance The distribution of a personalized discharge letter lowers the number of follow-up visits and implementing the intervention in a large eligible population results in large cost savings of €2,9 million and contributes to restrain the growing KC costs. |
| Item Type: | Essay (Master) |
| Clients: | Erasmus MC, Rotterdam, The Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine, 83 economics |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/83374 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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