Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment
- Type de publi. : Autre publication
- Date de publi. : 01/01/2008
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Auteurs :
Lionel PerrierNicola CautelaMagali MorelleNathalie HavetFrançoise DucimetièreAntoine LurkinJean-Yves BlayPierre BironDominique Ranchère-VinceAnne-Valérie DecouvelaerePhilippe ThiesseChristophe BergeronFrançois GillyGuy de LarocheDominic CellierMathieu LaramasThierry PhilipIsabelle Ray-Coquard
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Organismes :
Université de Lyon
Centre Léon Bérard [Lyon]
Groupe d'analyse et de théorie économique
Université de Lyon
Laboratoire d'Economie de la Firme et des Institutions
Université de Lyon
Centre Léon Bérard [Lyon]
Groupe d'analyse et de théorie économique
Université de Lyon
Groupe d'analyse et de théorie économique
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Santé Individu Société
Université de Lyon
Oncogénèse et progression tumorale
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Centre Hospitalier Lyon Sud [CHU - HCL]
Institut de Cancérologie de la Loire Lucien Neuwirth
Merck Santé - Lyon
Centre hospitalier universitaire de Grenoble
Université de Lyon
Centre Léon Bérard [Lyon]
Université de Lyon
Santé Individu Société
Résumé : Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified. Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment. Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions. Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy. Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.
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