Cost comparison study of two different follow-up protocols after surgery for oesophageal cancer

Background and aimCosts of follow-up strategies in patients after surgery for oesophageal cancer have not been evaluated. We therefore randomised 109 patients to standard outpatient clinic follow-up by a surgeon (n = 55) or home visits by a specialist nurse (n = 54) and compared costs between these two strategies.MethodCost comparisons included comprehensive data on hospital costs, diagnostic interventions and extramural care. Detailed information on health care consumption was obtained from a case record form at 6 weeks, and 3, 6, 9 and 12 months after randomisation.ResultsTotal medical costs were lower for nurse-led follow-up (€2592 versus €3798) than standard follow-up, although this difference was not statistically significant (p = 0.11). This advantage in the nurse-led follow-up group was mainly due to lower costs for follow-up visits (€234 versus €503; p < 0.001), and a trend towards lower costs for total intramural care (€1477 versus €2277; p = 0.19).ConclusionNurse-led follow-up of patients after oesophageal cancer surgery is likely to be cost effective and may even generate cost savings. The results of this study further support a specific role of nurses in the medical care of patients with malignant diseases.