Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment
Lionel Perrier
(1, 2, 3)
,
Nicola Cautela
(1, 4)
,
Magali Morelle
(1, 2, 3)
,
Nathalie Havet
(1, 3)
,
Françoise Ducimetière
(1, 2)
,
Antoine Lurkin
(1, 5)
,
Jean-Yves Blay
(1, 6)
,
Pierre Biron
(1, 2)
,
Dominique Ranchère-Vince
(1, 2)
,
Anne-Valérie Decouvelaere
(1, 2)
,
Philippe Thiesse
(1, 2)
,
Christophe Bergeron
(1, 2)
,
François Gilly
(1, 7)
,
Guy de Laroche
(8)
,
Dominic Cellier
(9)
,
Mathieu Laramas
(10)
,
Thierry Philip
(1, 2)
,
Isabelle Ray-Coquard
(1, 5)
1
Université de Lyon
2 Centre Léon Bérard [Lyon]
3 GATE - Groupe d'analyse et de théorie économique
4 LEFI - Laboratoire d'Economie de la Firme et des Institutions
5 SIS - Santé Individu Société
6 Oncogénèse et progression tumorale
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 Institut de Cancérologie de la Loire Lucien Neuwirth
9 Merck Santé - Lyon
10 CHU de Grenoble - Centre hospitalier universitaire de Grenoble
2 Centre Léon Bérard [Lyon]
3 GATE - Groupe d'analyse et de théorie économique
4 LEFI - Laboratoire d'Economie de la Firme et des Institutions
5 SIS - Santé Individu Société
6 Oncogénèse et progression tumorale
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 Institut de Cancérologie de la Loire Lucien Neuwirth
9 Merck Santé - Lyon
10 CHU de Grenoble - Centre hospitalier universitaire de Grenoble
Lionel Perrier
- Fonction : Auteur
- PersonId : 15600
- IdHAL : lionel-perrier
- ORCID : 0000-0003-4487-8723
- IdRef : 060772239
Magali Morelle
- Fonction : Auteur
- PersonId : 182509
- IdHAL : magali-morelle
- ORCID : 0000-0002-4694-4918
- IdRef : 253123240
Nathalie Havet
- Fonction : Auteur
- PersonId : 17495
- IdHAL : nathalie-havet
- ORCID : 0000-0001-7454-8771
- IdRef : 069561079
Jean-Yves Blay
- Fonction : Auteur
- PersonId : 935658
- IdHAL : jean-yves-blay
- ORCID : 0000-0001-7190-120X
- IdRef : 069035407
Isabelle Ray-Coquard
- Fonction : Auteur
- PersonId : 760354
- ORCID : 0000-0003-2472-8306
Résumé
Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified.
Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.
Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.
Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.
Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.
Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.
Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.
Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.
Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.
Domaines
Economies et financesFormat du dépôt | Fichier |
---|---|
Type de dépôt | Autre publication scientifique |
Titre |
en
Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment
|
Résumé |
en
Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified.<br />Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.<br />Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.<br />Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.<br />Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.
|
Auteur(s) |
Lionel Perrier
1, 2, 3
, Nicola Cautela
1, 4
, Magali Morelle
1, 2, 3
, Nathalie Havet
1, 3
, Françoise Ducimetière
1, 2
, Antoine Lurkin
1, 5
, Jean-Yves Blay
1, 6
, Pierre Biron
1, 2
, Dominique Ranchère-Vince
1, 2
, Anne-Valérie Decouvelaere
1, 2
, Philippe Thiesse
1, 2
, Christophe Bergeron
1, 2
, François Gilly
1, 7
, Guy de Laroche
8
, Dominic Cellier
9
, Mathieu Laramas
10
, Thierry Philip
1, 2
, Isabelle Ray-Coquard
1, 5
1
Université de Lyon
( 301088 )
- 92 rue Pasteur - CS 30122, 69361 Lyon Cedex 07
- France
2
Centre Léon Bérard [Lyon]
( 20549 )
- 28, rue Laennec 69373 LYON Cedex 08
- France
3
GATE -
Groupe d'analyse et de théorie économique
( 785 )
- 93 chemin des Mouilles 69130 ECULLY
- France
4
LEFI -
Laboratoire d'Economie de la Firme et des Institutions
( 14847 )
- Institut des Sciences de l'Homme 14 avenue Berthelot 69363 Lyon cedex 07
- France
5
SIS -
Santé Individu Société
( 79198 )
- Université Lumière Lyon 2 5 avenue Pierre Mendès France 69676 Bron cedex
- France
6
Oncogénèse et progression tumorale
( 2948 )
- 28, Rue Laennec 69373 Lyon Cedex 08
- France
7
CHLS -
Centre Hospitalier Lyon Sud [CHU - HCL]
( 353860 )
- 165 Chemin du Grand Revoyet
69495 Pierre-Bénite
- France
8
Institut de Cancérologie de la Loire Lucien Neuwirth
( 74079 )
- 108 Bis av. Albert Raimond 42270 Saint Priest en Jarez
- France
9
Merck Santé - Lyon
( 74080 )
- 37 rue Saint Romain F 69379 Lyon cedex 08
- France
10
CHU de Grenoble -
Centre hospitalier universitaire de Grenoble
( 74081 )
- BP 217 38043 Grenoble cedex 09
- France
|
Langue du document |
Anglais
|
Audience |
Non spécifiée
|
Date de publication |
2008
|
Description |
Working paper GATE 08-22
|
Vulgarisation |
Non
|
Domaine(s) |
|
Mots-clés |
en
Oncology, Sarcoma, Cost, Clinical guidelines, Efficacy, Medical Practices, Government Policy, Regulation, Public Health
|
Origine :
Fichiers produits par l'(les) auteur(s)
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