Patient-Level Re-Operative Costs for Oncological Margin Control following Breast Conserving Surgery
Association of Breast Surgery ePoster Library. Grant Y. 05/15/17; 166302; P041
Ms. Yasmin Grant
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Abstract
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Introduction:
High reoperation rates (20-30%) following breast conserving surgery (BCS) for positive margins are associated with increased physical and psychological morbidity and represents a likely significant and yet unestimated cost burden to the NHS. Our aim was to compare financial costs between patients undergoing successful BCS versus re-operative breast surgery.
Methods:
Financial data was retrieved retrospectively from 115 patients receiving BCS +/- re-operation between April to September 2015 using Patient-Level Information and Costing Systems (PLICS). Statistical analysis was conducted using SPSS (v20).
Results:
76 patients underwent definitive BCS and 39 patients underwent re-operative surgery. The total cost of definitive BCS was £232,897 with a median cost of £2,396 (IQR: £2086, range £923 - £8112). The total cost of definitive BCS and one re-operation (n=35) was £282,768 with a median cost of £3,799 (IQR: £10,761, range £1,498 - £28,705). The total cost of BCS and two re-operations (n=4) was £40,853 with a median cost of £10,387 (IQR: £6,539, range £5,934 - £14,145). The median cost of BCS and re-operation (n=39) was observed to be an additional £1,864 per patient compared to definitive BCS (n=76) (p<0.001).
Discussion:
This study is the first cost comparison between definitive BCS and re-operative surgery in the UK, interrogating direct patient level costs including operating theatre time, medical staffing, and laboratory investigations. Re-operation has significant cost implications and implementation of intra-operative margin technologies could result in both quality improvement and substantial savings to the NHS.
High reoperation rates (20-30%) following breast conserving surgery (BCS) for positive margins are associated with increased physical and psychological morbidity and represents a likely significant and yet unestimated cost burden to the NHS. Our aim was to compare financial costs between patients undergoing successful BCS versus re-operative breast surgery.
Methods:
Financial data was retrieved retrospectively from 115 patients receiving BCS +/- re-operation between April to September 2015 using Patient-Level Information and Costing Systems (PLICS). Statistical analysis was conducted using SPSS (v20).
Results:
76 patients underwent definitive BCS and 39 patients underwent re-operative surgery. The total cost of definitive BCS was £232,897 with a median cost of £2,396 (IQR: £2086, range £923 - £8112). The total cost of definitive BCS and one re-operation (n=35) was £282,768 with a median cost of £3,799 (IQR: £10,761, range £1,498 - £28,705). The total cost of BCS and two re-operations (n=4) was £40,853 with a median cost of £10,387 (IQR: £6,539, range £5,934 - £14,145). The median cost of BCS and re-operation (n=39) was observed to be an additional £1,864 per patient compared to definitive BCS (n=76) (p<0.001).
Discussion:
This study is the first cost comparison between definitive BCS and re-operative surgery in the UK, interrogating direct patient level costs including operating theatre time, medical staffing, and laboratory investigations. Re-operation has significant cost implications and implementation of intra-operative margin technologies could result in both quality improvement and substantial savings to the NHS.
Introduction:
High reoperation rates (20-30%) following breast conserving surgery (BCS) for positive margins are associated with increased physical and psychological morbidity and represents a likely significant and yet unestimated cost burden to the NHS. Our aim was to compare financial costs between patients undergoing successful BCS versus re-operative breast surgery.
Methods:
Financial data was retrieved retrospectively from 115 patients receiving BCS +/- re-operation between April to September 2015 using Patient-Level Information and Costing Systems (PLICS). Statistical analysis was conducted using SPSS (v20).
Results:
76 patients underwent definitive BCS and 39 patients underwent re-operative surgery. The total cost of definitive BCS was £232,897 with a median cost of £2,396 (IQR: £2086, range £923 - £8112). The total cost of definitive BCS and one re-operation (n=35) was £282,768 with a median cost of £3,799 (IQR: £10,761, range £1,498 - £28,705). The total cost of BCS and two re-operations (n=4) was £40,853 with a median cost of £10,387 (IQR: £6,539, range £5,934 - £14,145). The median cost of BCS and re-operation (n=39) was observed to be an additional £1,864 per patient compared to definitive BCS (n=76) (p<0.001).
Discussion:
This study is the first cost comparison between definitive BCS and re-operative surgery in the UK, interrogating direct patient level costs including operating theatre time, medical staffing, and laboratory investigations. Re-operation has significant cost implications and implementation of intra-operative margin technologies could result in both quality improvement and substantial savings to the NHS.
High reoperation rates (20-30%) following breast conserving surgery (BCS) for positive margins are associated with increased physical and psychological morbidity and represents a likely significant and yet unestimated cost burden to the NHS. Our aim was to compare financial costs between patients undergoing successful BCS versus re-operative breast surgery.
Methods:
Financial data was retrieved retrospectively from 115 patients receiving BCS +/- re-operation between April to September 2015 using Patient-Level Information and Costing Systems (PLICS). Statistical analysis was conducted using SPSS (v20).
Results:
76 patients underwent definitive BCS and 39 patients underwent re-operative surgery. The total cost of definitive BCS was £232,897 with a median cost of £2,396 (IQR: £2086, range £923 - £8112). The total cost of definitive BCS and one re-operation (n=35) was £282,768 with a median cost of £3,799 (IQR: £10,761, range £1,498 - £28,705). The total cost of BCS and two re-operations (n=4) was £40,853 with a median cost of £10,387 (IQR: £6,539, range £5,934 - £14,145). The median cost of BCS and re-operation (n=39) was observed to be an additional £1,864 per patient compared to definitive BCS (n=76) (p<0.001).
Discussion:
This study is the first cost comparison between definitive BCS and re-operative surgery in the UK, interrogating direct patient level costs including operating theatre time, medical staffing, and laboratory investigations. Re-operation has significant cost implications and implementation of intra-operative margin technologies could result in both quality improvement and substantial savings to the NHS.
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