The researchers found that the women in the two groups did not differ in terms of anxiety, depression, their satisfaction with care, how accessible they found the medical centre, or in medical outcomes measured by rates of cancer recurrence or death.
The difference in cost per year and per patient between the physician and nurse groups is modest, but transforms to nearly 900 per patient and five-year period, offering a substantial opportunity for reallocating resources since breast cancer is the most prevalent tumour worldwide said Dr Koinberg. Follow-up for breast cancer and cancer follow-up in general is an important area for developing new, less costly alternatives, so that scarce resources can be used more effectively. Our study indicates that follow-up after primary cancer treatment is an area where economic evaluation can be worthwhile.
She gave an example of the difference nurse-led follow-up could make in Sweden. If we estimate that 50% of the 60,000 women with prevalent breast cancer in Sweden are under active follow-up, the savings for Sweden alone would amount to 4.1 million per year if the findings of this study were applied.
Dr Koinberg concluded that individual countries needed to have coherent discussions about how they organised the follow-up of cancer patients. The majority of women treated within the last five years attend a follow-up programme. Thus, in total, these follow-up programmes consume large resources, even if the individual patient consultation entails only limited expense. Since there is no generally accepted strategy for a follow-up programme, these vary in their design from region to region and centre to centre. Recent research* has indicated that more intensive follow-up does not increase medical safety. Furthermore, there are indications that good
|Contact: Emma Mason|
ECCO-the European CanCer Organisation