A cost comparison study to review community versus acute hospital models of nursing care delivered to oncology patients

Abstract

Ireland's Sláintecare health plan is placing an increased focus on primary care. A community oncology nursing programme was developed to train community nurses to deliver care in the community. While the initial pilot was proven to be clinically safe, no cost evaluation was carried out. This study aims to compare the costs of providing cancer support services in a day-ward versus in the community. Methods: 183 interventions (40 in day-ward and 143 in community) were timed and costed using healthcare professional salaries and the Human Capital method. Results: From the healthcare provider perspective, the day-ward was a significantly cheaper option by an average of €17.13 (95% CI €13.72-€20.54, p < 0.001). From the societal perspective, the community option was cheaper by an average of €2.77 (95% CI-€3.02-€8.55), although this was a non-significant finding. Sensitivity analyses indicate that the community service may be significantly cheaper from the societal perspective. Conclusions: Given the demand for cost-viable options for primary care services, this programme may represent a national option for cancer care in Ireland when viewed from the societal perspective.

A mixed methods analysis of the monitoring of oral anti-cancer therapies

“…The aim would be both to free up capacity in the hospital and to make access to specialized care easier for patients. A previous examination of the costs associated with moving cancer care services to the community showed a reduction patient travel time by an average of 34.67 min (O'Mahony et al, 2020). This is relevant, given that any increase of travel time is particularly arduous for cancer patients (Zucca et al, 2011).…”

“…A sensitivity analysis examining the increased societal costs of patient travel was performed. An average patient travel time (38.42 min) to the hospital day unit derived from a previous study (O'Mahony et al, 2020) was applied to the face-to-face consultation costs. The extra societal cost was calculated using the Human Capital Method as previously discussed.…”

Hospital crowdedness evaluation and in-hospital resource allocation based on image recognition technology

“…We believe that the local government also needs to strengthen the construction of community hospitals, strengthen the training of family doctors, and improve the hierarchical diagnosis and treatment system 39 , 42 . Through community hospitals, family doctors and other means, to relieve the crowdedness of central hospitals and to reduce the time-consuming of patients 43 .…”

Habilidades sociais na especialidade da enfermagem em oncologia: estudo qualitativo

“…Dentre os diferentes contextos de prática dos enfermeiros destacamos o da oncologia para desenvolver este tema das HS, por reconhecê-la como uma especialidade de alta complexidade, neste caso, devido às questões psicoemocionais e sociais do processo de adoecimento por câncer, das consequências dos tratamentos, com repercussões para a pessoa cuidada, cuidador e profissional 6 . Comunicar notícias difíceis, lidar com sentimentos de vulnerabilidade própria, sofrimento, dor, e terminalidade da vida são algumas das dificuldades na abordagem da educação de enfermeiros na oncologia para aplicação das HS.…”

“…Ademais, tem-se que a pessoa e seus familiares que lidam com o diagnóstico de câncer e seus diversos desafios e sofrimentos, valorizam a comunicação na experiência com o enfermeiro e na educação em saúde quando recebem os cuidados, sendo a comunicação uma das principais HS que enfermeiros especialistas em enfermagem em oncologia demonstram conhecer, e que pode aumentar a qualidade dos cuidados, com melhorias no gerenciamento do câncer, em termos de respostas clínicas mais favoráveis, bem como em termos de organização e utilização dos recursos do sistema de saúde, implicando em resultados de custos mais sustentáveis 6 .…”