TY - JOUR
T1 - Compliance and efficiency before and after implementation of a clinical practice guideline for laryngeal carcinomas
AU - Van Agthoven, Michel
AU - Heule-Dieleman, Hélène A.G.
AU - Knegt, Paul P.
AU - Kaanders, Johannes H.A.M.
AU - Baatenburg De Jong, Robert J.
AU - Kremer, Bernd
AU - René Leemans, C.
AU - Marres, Henri A.M.
AU - Manni, Johannes J.
AU - Langendijk, Johannes A.
AU - Levendag, Peter C.
AU - Tjho-Heslinga, Reina E.
AU - De Jong, Joseph M.A.
AU - De Boer, Maarten F.
AU - Uyl-De Groot, Carin A.
PY - 2006/8
Y1 - 2006/8
N2 - We evaluated whether the implementation of a nationwide clinical practice guideline for diagnosis, treatment and follow-up of laryngeal carcinomas led to changes in hospital costs, balanced against clinical changes observed following the guideline's implementation. Charts of 822 patients with larynx carcinoma (459 treated before the introduction of the guideline and 363 thereafter) in five hospitals were retrospectively investigated. In all phases, no differences in total hospital costs were observed after the guideline's implementation. Total mean costs were € 3,207 (95%CI 3,091-3,395) for diagnosis, € 3,169 (2,153-4,182), € 5,026 (3,996-6,057), € 6,458 (5,579-7,337), € 8,037 (7,469-8,606), € 12,765 (10,763-14,769), € 19,227 (16,848-21,605) for treatment of dysplasia, carcinoma in situ, T1, T2, T3 and T4 carcinoma, respectively, and € 1,856 (1,491-2,220) for 1 year disease-free follow-up. In an earlier study, we observed several positive changes after the guideline's implementation. Balanced against the equal costs before and after the guideline's implementation, we conclude that the efficiency of the care process improved.
AB - We evaluated whether the implementation of a nationwide clinical practice guideline for diagnosis, treatment and follow-up of laryngeal carcinomas led to changes in hospital costs, balanced against clinical changes observed following the guideline's implementation. Charts of 822 patients with larynx carcinoma (459 treated before the introduction of the guideline and 363 thereafter) in five hospitals were retrospectively investigated. In all phases, no differences in total hospital costs were observed after the guideline's implementation. Total mean costs were € 3,207 (95%CI 3,091-3,395) for diagnosis, € 3,169 (2,153-4,182), € 5,026 (3,996-6,057), € 6,458 (5,579-7,337), € 8,037 (7,469-8,606), € 12,765 (10,763-14,769), € 19,227 (16,848-21,605) for treatment of dysplasia, carcinoma in situ, T1, T2, T3 and T4 carcinoma, respectively, and € 1,856 (1,491-2,220) for 1 year disease-free follow-up. In an earlier study, we observed several positive changes after the guideline's implementation. Balanced against the equal costs before and after the guideline's implementation, we conclude that the efficiency of the care process improved.
KW - Compliance
KW - Guideline adherence
KW - Health care costs
KW - Laryngeal neoplasms
KW - Larynx cancer
UR - http://www.scopus.com/inward/record.url?scp=33745933074&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00405-006-0062-6
DO - https://doi.org/10.1007/s00405-006-0062-6
M3 - Article
C2 - 16699832
SN - 0937-4477
VL - 263
SP - 729
EP - 737
JO - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
IS - 8
ER -