Patient satisfaction regarding outpatient mastectomy in Saint-Nazaire hospital center

Simoni, Marzia; Laurent, François; Évrard, Serge; Bruneau, L.; Allio, N.; Randet, Mélanie

doi:10.1016/j.jogoh.2017.02.011

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Reducing ‘routine’ seroma aspiration requires both patient and clinician education and engagement. Reducing drain use decreases costs and outpatient attendances with evidence demonstrating that this strategy does not prolong the time for the seroma to resolve and that it is acceptable to patients [7, 8, 29, 30].…”

Section: Discussionmentioning

confidence: 99%

Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome

Jackson

MacInnes

Nicholson

et al. 2019

Cureus

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Introduction Use of drains after mastectomy remains highly variable. This study aimed to establish whether simple mastectomy managed without a drain would cost less than the same procedure managed with a drain and whether there would be any difference in complications.Methods Prospective data were collected on all patients undergoing simple mastectomy ± sentinel lymph node biopsy over sixteen months. Surgeons decided intra-operatively whether to place a drain. Data included operative details, mastectomy weight, length of stay and postoperative complications. Costing data were identified by combining hospital finance costs for admission and follow-up appointments along with the cost of consumables.Results One hundred and thirty mastectomies were performed on 119 patients. There was a significant difference in mastectomy weight between drain group patients (n=80, median: 730g) and no drain group patients (n=50, median: 424g) (p=<0.001). The mean cost for drain group patients was £639.77 whilst for the no drain group was £365.46, indicating a potential unit saving of £21944.93 over sixteen months. Length of stay was shorter in the no drain group (range: 1-2 days) than the drain group (range: 1-4 days). The presence or absence of drains did not influence complication rates, with no change in seroma interventions (p=0.803).Conclusions Managing simple mastectomy patients without a drain resulted in no increase in complications or subsequent interventions for seroma. Significant cost savings to both the hospital and to the patient can be achieved by omitting drain use. Routine use of drains in patients undergoing simple mastectomy ± SNB may be unnecessary and costly.

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Section: Discussionmentioning

confidence: 99%

Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome

Jackson

MacInnes

Nicholson

et al. 2019

Cureus

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“…In contrast, approximately half of total mastectomy patients still are treated in the inpatient setting despite growing evidence of equivalent safety and improved patient satisfaction with ambulatory mastectomy. 5 – 9 …”

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confidence: 99%

Value of Ambulatory Modified Radical Mastectomy

et al. 2023

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Background Modified radical mastectomy (MRM) still is largely performed in inpatient settings. This study sought to determine the value (expenditures and complications) of ambulatory MRM. Methods Health Care Utilization Project (HCUP) state databases from 2016 were queried for patients who underwent MRM. The study examined rates of 30-day readmission for surgical-site infection (SSI) or hematoma, charges by index care setting, and predictors of 30-day readmission. Results Overall, 8090 patients underwent MRM: 5113 (63 %) inpatient and 2977 (37 %) ambulatory patients. Compared with the patients who underwent inpatient MRM, those who underwent ambulatory MRM were older (61 vs. 59 years), more often white (66 % vs. 57 %), in the lowest income quartile (28 % vs. 21 %), insured by Medicare (43 % vs. 33 %) and residents in a small metro area (6 % vs. 4 %) (all p < 0.01). Of the 5113 patients treated as inpatients, 126 (2.5 %) were readmitted, whereas 50 (1.7 %) of the ambulatory patients were readmitted ( p = 0.02). The adjusted charge for inpatient MRM without readmission was $113,878 (range, $107,355–120,402) compared with $94,463 (range, $86,021–102,907) for ambulatory MRM, and the charge for inpatient MRM requiring readmission was $159,355 (range, $147,142–171,568) compared with $139,940 (range, $125,808–154,073) for ambulatory MRM (all p < 0.01). This difference remained significant after adjustment for hospital length of stay. Adjusted logistic regression showed that the ambulatory setting was protective for readmission (odds ratio, 0.49; 95 % confidence interval, 0.35–0.70; p < 0.01). Conclusions The analyses suggest that ambulatory MRM is both safe and less expensive. The findings advocate that MRM, a last holdout of inpatient care within breast surgical oncology, can be transitioned to the ambulatory setting for appropriate patients.

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