Abstract
BackgroundThe objective of this study is to evaluate the cost-effectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction.MethodsThis is a comparative trial of a prospective treatment group managed on a postoperative clinical care pathway and a historical group managed prior to pathway implementation. Effectiveness outcomes evaluated were total hospital days, return to OR, readmission to ICU and rate of pulmonary complications. Costing perspective was from the government payer.Results118 patients were included in the study. All outcomes demonstrated that the postoperative pathway group was both more effective and less costly, and is therefore a dominant clinical intervention. The overall mean pre- and post-pathway costs are $22,733 and $16,564 per patient, respectively. The incremental cost reduction associated with the postoperative pathway was $6,169 per patient.ConclusionImplementing the postoperative clinical care pathway in patients undergoing head and neck oncologic surgery with reconstruction resulted in improved clinical outcomes and reduced costs.
Highlights
The objective of this study is to evaluate the cost-effectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction
Due to the growing concern about the fiscal sustainability of health care systems around the globe, identifying clinical interventions to improve the cost-effectiveness of managing head and neck squamous cell carcinoma (HNSCC) is important [2]
The objective of this study was to evaluate the costeffectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction
Summary
The objective of this study is to evaluate the cost-effectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction. The majority of the treatment expenditure is consumed by hospitalization costs, in the postoperative period [1] Postoperative care in these patients is complex, with lengthy hospitalization and recovery periods. Due to the growing concern about the fiscal sustainability of health care systems around the globe, identifying clinical interventions to improve the cost-effectiveness of managing HNSCC is important [2]. The pathway determines the timing and co-ordination of all essential interventions provided by multiple health care disciplines to minimize delays, omissions and duplications and maximize effectiveness and efficiency [3,4]
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