Laudicella, Mauro, Walsh, Brendan, Burns, Elaine et al. (2 more authors) (2018) What is the impact of rerouting a cancer diagnosis from emergency presentation to GP referral on resource use and survival? Evidence from a population-based study. BMC Cancer. 394. ISSN 1471-2407
Abstract
Background: Studies on alternative routes to diagnosis stimulated successful policy interventions reducing the number of emergency diagnoses and associated mortality risk. A dearth of evidence on the costs of such interventions might prevent new policies from achieving more ambitious targets. Methods: We conducted a retrospective cohort study on the population of colorectal (88,051), breast (90,387), prostate (96,219), and lung (97,696) cancer patients diagnosed after a GP referral or an emergency presentation and reported in the Cancer Registry of England. Resource use and survival were compared 1 year before and 5 years after diagnosis (3 years for lung), including the costs of GP referrals not converted into a positive diagnosis. Risk-adjusted statistical models were used to calculate the effect of rerouting patient' diagnoses from emergency presentation to GP referral. Results: Rerouting a cancer diagnosis results in a relatively small additional costs to the National Health System against additional years of life saved to the patient. The cost per year of life saved is £6456 in colorectal, £1057 in breast, £662 in prostate (savings), and £819 in lung cancer. Reducing the overall prevalence of emergency presentations to the level achieved by the 20% of Clinical Commissioning Groups with the lowest prevalence would result in £11,481,948 against 1863 years of life saved for Colorectal, £847,750 against 889 years for breast, £943,434 (cost savings) against 1195 years for prostate, and £609,938 against 1011 years for lung cancer. Conclusion: Redirecting diagnoses from emergency presentation to GP referral appears an achievable target that can produce large benefits to patients against modest additional costs to the National Health System.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s). 2018 |
Keywords: | Early diagnosis, Emergency, Hospital costs, Primary care, Route to diagnosis, Survival |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York) |
Depositing User: | Pure (York) |
Date Deposited: | 24 Oct 2019 15:10 |
Last Modified: | 06 Dec 2023 13:23 |
Published Version: | https://doi.org/10.1186/s12885-018-4274-0 |
Status: | Published |
Refereed: | Yes |
Identification Number: | https://doi.org/10.1186/s12885-018-4274-0 |
Related URLs: |
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Description: What is the impact of rerouting a cancer diagnosis from emergency presentation to GP referral on resource use and survival? Evidence from a population-based study
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