The study found that over a five-year period the cost of follow-up care was 630 euros per person per year for patients who saw a physician and 495 euros per person per year for those who saw specialist cancer nurses. Over a five-year period this made a difference of 866 euros per patient – a modest saving per patient, but one that would enable substantial savings to be made in a country’s health budget as breast cancer is the most prevalent tumour worldwide.
Dr IngaLill Koinberg, who is both a nurse and medical doctor at the Department of Research and Development, Hospital Varberg and Kristianstad University, Sweden, said: “These results showed that follow-up led by specialist nurses, with check-ups on demand, were 20 percent less expensive than routine follow-up visits to the physician. The main difference in cost between physician-led follow-up and nurse-led follow-up was explained by the number of visits to the physician. There were 21 percent more contacts with the physician in the physician group than in the nurse group.”
Koinberg and her colleagues randomised 264 breast cancer patients to two different follow-up groups in a prospective trial. Women in the physician group had routine medical follow-ups by a physician, involving four visits per year in the first two years, then examinations twice a year for up to five years, and annually thereafter.
In the nurse group, patients saw a specialist nurse three months after the initial visit to the physician following radiotherapy. They were told how to recognise recurrence in the breast, skin, axillary nodes and scar tissue, and to telephone the nurse if they had any questions or symptoms of cancer recurrence. In addition, they had an annual mammography, and after three years they were referred back to the routine mammography screening programme. “Our study indicates that follow-up after primary cancer treatment is an area where economic evaluation can be worthwhile”, said Koinberg.
MEDICA.de; Source: ECCO-the European CanCer Organisation