未经证实:插入前列腺基准标记的通常做法涉及插入和模拟之间至少一周的延迟。实施了基于证据的实践更改,从而在放射疗法模拟的同一天插入了基准标记。这项研究的目的是量化与这种实践变化相关的卫生服务成本和临床结果。
UNASSIGNED:从当地卫生服务的角度进行了成本最小化分析。进行了回顾性图表审核,以收集实施前队列中的149名患者和实施后队列中的138名患者的数据。计算并比较了两个队列的插入和模拟相关费用;这包括农村和偏远患者的补贴旅行费用。对所有患者测量计划CT和首次治疗CBCT上的基准标记位置,作为水肿的替代临床结果量度。
未经ASSIGNED:改变实践后,卫生服务平均为每位患者节省了361AU$(CI$311-$412)。实施前后的基准标记位置没有显着差异(p<0.05)。
UNASSIGNED:在同一天进行插入和放射治疗模拟的实践改变为卫生系统节省了大量资金,在不影响临床结果的情况下。所需患者就诊人数的减少对农村和偏远地区人口具有真正的影响。这种做法的改变增加了最佳做法医疗保健对那些最有可能错过的人的价值和可及性。
UNASSIGNED: Usual practice for the insertion of prostate fiducial markers involves at least one week delay between insertion and simulation. An evidence-based practice change was implemented whereby fiducial marker insertion occurred on the same day as radiotherapy simulation. The aim of this study was to quantify the health service costs and clinical outcomes associated with this practice change.
UNASSIGNED: A cost-minimisation analysis was undertaken from the perspective of the local health service. A retrospective chart audit was conducted to collect data on 149 patients in the pre-implementation cohort and 138 patients in the post-implementation cohort. Associated costs with insertion and simulation were calculated and compared across the two cohorts; this included subsided travel costs for rural and remote patients. Fiducial marker positions on planning CT and first treatment CBCT were measured for all patients as the surrogate clinical outcome measure for oedema.
UNASSIGNED: The health service saved an average of AU$ 361 (CI $311 - $412) per patient after the practice change. There was no significant difference in fiducial marker position pre- and post- implementation (p < 0.05).
UNASSIGNED: The practice change to perform insertion and radiotherapy simulation on the same day resulted in substantial savings to the health system, without compromising clinical outcomes. The decrease in number of required patient attendances is of real consequence to rural and remote populations. The practice change increases both the value and accessibility of best-practice health care to those most at risk of missing out.