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    The effects of a multidisciplinary high-throughput skin clinic on healthcare costs of organ transplant recipients.

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    Authors
    Gordon, LG
    Rodriguez-Acevedo, AJ
    Papier, K
    Khosrotehrani, K
    Isbel, N
    Campbell, S
    Griffin, A
    Green, Adèle C
    Affiliation
    QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia
    Issue Date
    2019
    
    Metadata
    Show full item record
    Abstract
    BACKGROUND: A long-term complication among organ transplant recipients (OTRs) is skin malignancies which are associated with level and duration of immunosuppressive treatment, sun exposure and age. Dermatological surveillance is recommended for OTRs at high risk of skin malignancies, but evidence is lacking on the benefits of such services. OBJECTIVE: To examine the economic impact on patients and on the hospital service of a multidisciplinary high-throughput skin cancer Clinic in Brisbane, Australia, dedicated to dermatological and surgical care of high-risk OTRs. METHODS: In a pre-post design, hospital admission and cost data were obtained for 101 consecutively-enrolled study participants from 12 months prior to the introduction of the Clinic (to February 2016), the 3-month 'run-in' period (March to May 2016), and 12 months subsequent (to June 2017). Differences between pre- and post-Clinic hospital costs were tested using non-parametric bootstrapping and interrupted time series analysis. A survey of patient out-of-pocket costs and perceived financial burden was also undertaken during the Clinic. RESULTS: Overall hospital costs were higher after the Clinic but 3-monthly hospital costs for skin procedures trended downwards. Despite 3-monthly mean hospital visits increasing from 85 to 314, mean 3-monthly costs reduced by AU$1,491 (p<0.001) indicating greater cost-efficiency. Total patient out-of-pocket costs were AU$18,377 over 3 months. CONCLUSION: Clinical costing data revealed higher, more rapid throughput, and significantly lower per patient costs pre- and post- establishment of a multidisciplinary skin cancer Clinic for OTRs.
    Citation
    Gordon LG, Rodriguez-Acevedo AJ, Papier K, Khosrotehrani K, Isbel N, Campbell S, et al. The effects of a multidisciplinary high-throughput skin clinic on healthcare costs of organ transplant recipients. J Eur Acad Dermatol Venereol. 2019 Feb 1.
    Journal
    Journal of the European Academy of Dermatology and Venereology
    URI
    http://hdl.handle.net/10541/621599
    DOI
    10.1111/jdv.15458
    PubMed ID
    30706970
    Additional Links
    https://dx.doi.org/10.1111/jdv.15458
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1111/jdv.15458
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research

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