Document Server@UHasselt >
Research >
Research publications >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18966

Title: Cost-Effectiveness of Reduced Waiting Time for Head and Neck Cancer Patients due to a Lean Process Redesign
Authors: SIMONS, Pascale
Ramaekers, Bram
Hoebers, Frank
Kross, Kenneth
Marneffe, Wim
Pijls-Johannesma, Madelon
Vandijck, Dominique
Issue Date: 2015
Citation: VALUE IN HEALTH, 18 (5), p. 587-596
Abstract: Background: Compared with new technologies, the redesign of care processes is generally considered less attractive to improve patient outcomes. Nevertheless, it might result in better patient outcomes, without further increasing costs. Because early initiation of treatment is of vital importance for patients with head and neck cancer (HNC), these care processes were redesigned. Objectives: This study aimed to assess patient outcomes and cost-effectiveness of this redesign. Methods: An economic (Markov) model was constructed to evaluate the biopsy process of suspicious lesion under local instead of general anesthesia, and combining computed tomography and positron emission tomography for diagnostics and radiotherapy planning. Patients treated for HNC were included in the model stratified by disease location (larynx, oropharynx, hypopharynx, and oral cavity) and stage (I–II and III–IV). Probabilistic sensitivity analyses were performed. Results: Waiting time before treatment start reduced from 5 to 22 days for the included patient groups, resulting in 0.13 to 0.66 additional quality-adjusted life-years. The new workflow was cost-effective for all the included patient groups, using a ceiling ratio of €80,000 or €20,000. For patients treated for tumors located at the larynx and oral cavity, the new workflow resulted in additional quality-adjusted lifeyears, and costs decreased compared with the regular workflow. The health care payer benefited €14.1 million and €91.5 million, respectively, when individual net monetary benefits were extrapolated to an organizational level and a national level. Conclusions: The redesigned care process reduced the waiting time for the treatment of patients with HNC and proved cost-effective. Because care improved, implementation on a wider scale should be considered.
Notes: Simons, PAM (reprint author), MAASTRO Clin, Dr Tanslaan 12, Maastricht, Netherlands. pascale.simons@maastro.nl
URI: http://hdl.handle.net/1942/18966
DOI: 10.1016/j.jval.2015.04.003
ISI #: 000360097700007
ISSN: 1098-3015
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

Files in This Item:

Description SizeFormat
N/A1.42 MBAdobe PDF
published version1.3 MBAdobe PDF

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.