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Thoracic Oncology Multidisciplinary Clinic Reduces Unnecessary Health Care Expenditure Used in the Workup of Patients With Non-small-cell Lung Cancer.

Abstract：

BACKGROUND:National costs of lung cancer care exceed $12 billion. We investigate the resource-savings benefit of a single-day thoracic oncology multidisciplinary clinic (MDC) in the diagnostic period prior to non-small-cell lung cancer (NSCLC) treatment. MATERIALS AND METHODS:From July 2007 to January 2015, patients with NSCLC treated with multimodality therapy at a tertiary hospital-based cancer center in Maryland were identified. Patient and treatment details were collected. Health care resources utilized in the 90 days prior to receipt of first oncologic treatment were identified using billed activity codes. Associated total charges, including professional fees and hospital-based technical fees, were identified and inflated to 2014 dollars using the Consumer Price Index. Codes were categorized into provider visits, procedures, pathology/laboratory, radiology, and other tests. χ2, Student t, and Wilcoxon rank-sum tests compared charges of patients seen in and out of the MDC. RESULTS:Two-hundred ninety-seven (non-MDC = 161, 54%; MDC = 136, 46%) of 308 patients identified had total charges available. Patients seen through MDC had on average a 23% decrease in total charges per patient incurred ($5839 savings; range, $5213-$6464) compared with patients seen through non-MDC settings. Evaluation through MDC reduced the average number of provider visits per patient (non-MDC, 6.8 vs. MDC, 4.8; P < .01) prior to treatment start, which led to a 50% (average $3092; range, $2451-$3732) reduction in provider charges per patient (P < .01). CONCLUSIONS:Evaluation of patients with NSCLC through a coordinated single-day MDC reduced hospital charges per patient by 23% during the diagnostic period prior to treatment when compared with evaluation through traditional referral-based thoracic oncology clinics.

journal_name

Clin Lung Cancer

journal_title

Clinical lung cancer

authors

Voong KR,Liang OS,Dugan P,Torto D,Padula WV,Senter JP,Lang M,Hooker CM,Feliciano J,Broderick S,Yarmus L,Khanna K,Narang A,Hales RK

doi

10.1016/j.cllc.2019.02.010

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

e430-e441

issue

eissn

1525-7304

issn

1938-0690

pii

S1525-7304(19)30060-9

journal_volume

pub_type

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Thoracic Oncology Multidisciplinary Clinic Reduces Unnecessary Health Care Expenditure Used in the Workup of Patients With Non-small-cell Lung Cancer.