Cost-effectiveness of general practitioner- versus surgeon-led colon cancer survivorship care: an economic evaluation alongside a randomised controlled trial

被引:0
|
作者
Vos, Julien A. M. [1 ,2 ]
El Alili, Mohamed [2 ,3 ]
Duineveld, Laura A. M. [1 ]
Wieldraaijer, Thijs [1 ]
Wind, Jan [1 ]
Sert, Edanur C. [1 ]
Donkervoort, Sandra [4 ]
Govaert, Marc J. P. M. [5 ]
van Geloven, Nanette A. W. [6 ]
van de Ven, Anthony W. H. [7 ]
Heuff, Gijsbert [8 ]
van Weert, Henk C. P. M. E. [1 ,2 ]
Bosmans, Judith M. [3 ]
van Asselt, Kristel [1 ,2 ]
机构
[1] Univ Amsterdam, Dept Gen Practice, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[2] Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Fac Sci, Dept Hlth Sci, Boechorstr 7, NL-1081 BT Amsterdam, Netherlands
[4] OLVG Hosp, Dept Surg, Oosterpk 9, NL-1091 AC Amsterdam, Netherlands
[5] Dijklander Hosp, Dept Surg, Maelsonstr 3, NL-1624 NP Hoorn, Netherlands
[6] Tergooi Hosp, Dept Surg, Riebeeckweg 212, NL-1213 XZ Hilversum, Netherlands
[7] Flevoziekenhuis, Dept Surg, Hosp weg 1, NL-1315 RA Almere, Netherlands
[8] Spaarne Gasthuis, Dept Surg, Spaarnepoort 1, NL-2134 TM Hoofddorp, Netherlands
关键词
Colon cancer; Primary health care; Quality of healthcare; Cancer survivors; Cost-benefit analysis; QUALITY-OF-LIFE; HEALTH-CARE; FOLLOW-UP; QLQ-C30; MODELS;
D O I
10.1007/s11764-023-01383-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PurposeThe aim of this study is to assess cost-effectiveness of general practitioner (GP) versus surgeon-led colon cancer survivorship care from a societal perspective.MethodsWe performed an economic evaluation alongside the I CARE study, which included 303 cancer patients (stages I-III) who were randomised to survivorship care by a GP or surgeon. Questionnaires were administered at baseline, 3-, 6-, 12-, 24- and 36-months. Costs included healthcare costs (measured by iMTA MCQ) and lost productivity costs (SF-HLQ). Disease-specific quality of life (QoL) was measured using EORTC QLQ-C30 summary score and general QoL using EQ-5D-3L quality-adjusted life years (QALYs). Missing data were imputed. Incremental cost-effectiveness ratios (ICERs) were calculated to relate costs to effects on QoL. Statistical uncertainty was estimated using bootstrapping.ResultsTotal societal costs of GP-led care were significantly lower compared to surgeon-led care (mean difference of - euro3895; 95% CI - euro6113; - euro1712). Lost productivity was the main contributor to the difference in societal costs (- euro3305; 95% CI - euro5028; - euro1739). The difference in QLQ-C30 summary score over time between groups was 1.33 (95% CI - 0.049; 3.15). The ICER for QLQ-C30 was - 2073, indicating that GP-led care is dominant over surgeon-led care. The difference in QALYs was - 0.021 (95% CI - 0.083; 0.040) resulting in an ICER of 129,164.ConclusionsGP-led care is likely to be cost-effective for disease-specific QoL, but not for general QoL.Implications for cancer survivorsWith a growing number of cancer survivors, GP-led survivorship care could help to alleviate some of the burden on more expensive secondary healthcare services.
引用
收藏
页码:1393 / 1402
页数:10
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