4150 Is telephone follow-up by specialist nurses a cost effective approach?

Abstract

Background: This paper will report on the findings from an economic evaluation of traditional hospital follow-up versus telephone follow-up by specialist breast care nurses for patients treated for breast cancer in the
United Kingdom (UK).
Materials and Methods: We conducted a cost minimisation analysis from a National Health Service (NHS) perspective using data from a randomised controlled trial that demonstrated equivalence between hospital and telephone follow-up in terms of psychological morbidity; 374 participants at low-moderate risk of recurrence were recruited to the study. The study was carried out at two hospitals in the North West of Engalnd. In a primary analysis we compared NHS resource use for routine follow-up (i.e. consultations, investigations and referrals) during a mean follow-up period of 24 months. Secondary analyses included patient and carer travel and productivity costs incurred and the NHS and personal social services costs of care in the minority of patients who developed a recurrence of
their breast cancer.
Results: Participants in the telephone follow-up group had approximately 20% extra consultations (634 versus 524). Telephone consultations were of longer duration and conducted by senior nurses whereas hospital clinic appointments were of shorter duration and often conducted by junior medical staff; this resulted in higher routine follow-up costs in the telephone follow-up group (mean difference £55, 95% bCI £29-£77). There were no significant differences in the costs of treating recurrence between groups. Participants receiving hospital follow-up had significantly higher travel and
productivity costs (mean difference £47; 95% bCI £40-£55).
Conclusions: Telephone follow-up by specialist nurses may be a useful strategy for reducing the burden on busy hospital clinics and providing a quality service. Although patients and carers will have fewer costs with
telephone follow-up, this approach will not necessarily lead to cost or salary savings for the health service.