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Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment

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Author Info

  • Lionel Perrier

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard, GATE - Groupe d'analyse et de théorie économique - CNRS : UMR5824 - Université Lumière - Lyon II - Ecole Normale Supérieure Lettres et Sciences Humaines)

  • Nicola Cautela

    (Université de Lyon - Université de Lyon, LEFI - Laboratoire d'Economie de la Firme et des Institutions - Université Lumière - Lyon II : EA4012)

  • Magali Morelle

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard, GATE - Groupe d'analyse et de théorie économique - CNRS : UMR5824 - Université Lumière - Lyon II - Ecole Normale Supérieure Lettres et Sciences Humaines)

  • Nathalie Havet

    ()
    (Université de Lyon - Université de Lyon, GATE - Groupe d'analyse et de théorie économique - CNRS : UMR5824 - Université Lumière - Lyon II - Ecole Normale Supérieure Lettres et Sciences Humaines)

  • Françoise Ducimetière

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Antoine Lurkin

    (Université de Lyon - Université de Lyon, SIS - Santé Individu Société - Université Claude Bernard - Lyon I - Université Lumière - Lyon II : EA4129 - Université Jean Moulin - Lyon III - Hospices civils de Lyon)

  • Jean-Yves Blay

    (Université de Lyon - Université de Lyon, Oncogénèse et progression tumorale - INSERM : U590 - Université Claude Bernard - Lyon I - CRLCC Léon Bérard)

  • Pierre Biron

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Dominique Ranchère-Vince

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Anne-Valérie Decouvelaere

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Philippe Thiesse

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Christophe Bergeron

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • François Gilly

    (Université de Lyon - Université de Lyon, Centre Hospitalier Lyon Sud - Centre hospitalier Lyon Sud)

  • Guy De Laroche

    (Institut de Cancérologie de la Loire - Institut de Cancérologie de la Loire)

  • Dominic Cellier

    (Merck Santé - Lyon - Merck Serono)

  • Mathieu Laramas

    (CHU de Grenoble - Centre hospitalier universitaire de Grenoble - Centre Hospitalier Universitaire de Grenoble)

  • Thierry Philip

    (Université de Lyon - Université de Lyon, Centre Léon Bérard - CRLCC Léon Bérard)

  • Isabelle Ray-Coquard

    (Université de Lyon - Université de Lyon, SIS - Santé Individu Société - Université Claude Bernard - Lyon I - Université Lumière - Lyon II : EA4129 - Université Jean Moulin - Lyon III - Hospices civils de Lyon)

Abstract

Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified.Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.

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Bibliographic Info

Paper provided by HAL in its series Post-Print with number halshs-00322614.

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Date of creation: 2008
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Handle: RePEc:hal:journl:halshs-00322614

Note: View the original document on HAL open archive server: http://halshs.archives-ouvertes.fr/halshs-00322614/en/
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Web page: http://hal.archives-ouvertes.fr/

Related research

Keywords: Oncology; Sarcoma; Cost; Clinical guidelines; Efficacy; Medical Practices; Government Policy; Regulation; Public Health;

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  1. McDonald, John F & Moffitt, Robert A, 1980. "The Uses of Tobit Analysis," The Review of Economics and Statistics, MIT Press, vol. 62(2), pages 318-21, May.
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