TY - JOUR
T1 - Specialization Reduces Costs Associated With Colon Cancer Care
T2 - A Cost Analysis
AU - Leleannec, Isabelle C.
AU - Madoff, Robert D.
AU - Jensen, Christine C.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - BACKGROUND: Colorectal surgeons have been reported to have superior outcomes to general surgeons in the management of colon cancer, but it is unclear whether this leads to a difference in costs associated with cancer care. OBJECTIVE: This study aimed to investigate whether colorectal surgeons versus general surgeons performing elective colectomies for colon cancer resulted in cost savings. DESIGN: A decision analysis model was built to evaluate the cost of care. One-way and Monte Carlo sensitivity analyses were performed to test the assumptions of the model. SETTING: Data for the model were taken from previously published studies. PATIENTS: This study included a simulated cohort of patients undergoing elective colectomy for colon cancer. MAIN OUTCOME MEASURES: Total cost of care from the societal and health care system perspectives. RESULTS: In the base case scenario, from the societal perspective, colectomy performed by a colorectal surgeon costs $38,798 during the 5-year window versus $46,571 when performed by a general surgeon (net savings, $7773). From the health care system perspective, surgery performed by a colorectal surgeon costs $25,125 versus surgery performed by a general surgeon, which costs $29,790 (net savings, $4665). In probabilistic sensitivity analyses, surgeries performed by colorectal surgeons were cost saving or equivalent to those performed by general surgeons in 997 of 1000 simulations in the societal perspective and 989 of 1000 simulations in the health care system perspective. Overall, this finding was primarily driven by differences in reported overall recurrence rates and patient loss of productivity. LIMITATIONS: The limitation of this study was reliance on published data, some of which included rectal cancer cases. CONCLUSIONS: In our decision analysis model, elective colectomies for colon cancer had lower associated costs when performed by colorectal versus general surgeons. See Video Abstract at http://links.lww.com/DCR/B974.
AB - BACKGROUND: Colorectal surgeons have been reported to have superior outcomes to general surgeons in the management of colon cancer, but it is unclear whether this leads to a difference in costs associated with cancer care. OBJECTIVE: This study aimed to investigate whether colorectal surgeons versus general surgeons performing elective colectomies for colon cancer resulted in cost savings. DESIGN: A decision analysis model was built to evaluate the cost of care. One-way and Monte Carlo sensitivity analyses were performed to test the assumptions of the model. SETTING: Data for the model were taken from previously published studies. PATIENTS: This study included a simulated cohort of patients undergoing elective colectomy for colon cancer. MAIN OUTCOME MEASURES: Total cost of care from the societal and health care system perspectives. RESULTS: In the base case scenario, from the societal perspective, colectomy performed by a colorectal surgeon costs $38,798 during the 5-year window versus $46,571 when performed by a general surgeon (net savings, $7773). From the health care system perspective, surgery performed by a colorectal surgeon costs $25,125 versus surgery performed by a general surgeon, which costs $29,790 (net savings, $4665). In probabilistic sensitivity analyses, surgeries performed by colorectal surgeons were cost saving or equivalent to those performed by general surgeons in 997 of 1000 simulations in the societal perspective and 989 of 1000 simulations in the health care system perspective. Overall, this finding was primarily driven by differences in reported overall recurrence rates and patient loss of productivity. LIMITATIONS: The limitation of this study was reliance on published data, some of which included rectal cancer cases. CONCLUSIONS: In our decision analysis model, elective colectomies for colon cancer had lower associated costs when performed by colorectal versus general surgeons. See Video Abstract at http://links.lww.com/DCR/B974.
KW - Colon cancer
KW - Colorectal surgery
KW - Cost analysis
KW - Economic evaluation
KW - Surgical specialization
UR - http://www.scopus.com/inward/record.url?scp=85138511438&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138511438&partnerID=8YFLogxK
U2 - 10.1097/DCR.0000000000002370
DO - 10.1097/DCR.0000000000002370
M3 - Article
C2 - 35522784
AN - SCOPUS:85138511438
SN - 0012-3706
VL - 66
SP - 1185
EP - 1193
JO - Diseases of the colon and rectum
JF - Diseases of the colon and rectum
IS - 9
ER -
