Introduction/Background Risk stratification has resulted in Patient-initiated follow-up (PIFU) being introduced for low-risk endometrial cancer (LREC) in place of routine hospital follow-up (HFU). The financial benefit to the healthcare economy and the patient of PIFU as compared to HFU as yet to be explored.
Methodology Women diagnosed with G1/2 Stage 1A EC enrolled for PIFU were included. Data on the number of appointments and telephone calls actually attended was collected prospectively, and costs calculated at £80/appointment and £43.33/telephone call (assuming £130/hour). This was compared with the cost of the scheduled HFU appointments. Patient travel time to appointments (car and public transport) and mileage were calculated. Travel cost was calculated to be 40p/mile and £2.50 car-parking.
Results In total 188 women were enrolled between 2014–2018, median follow-up 1.9 years (range 0.1–3.9 years). Median participant age was 61 years and median travelling distance to the hospital was 15.4 miles (maximum 74 miles). There was no public transport option for two patients. The cohort had been scheduled to have attended 1106 appointments with HFU, whereas only 56 appointments were required with PIFU, 94.9% reduction in clinic costs: HFU £88,480 HFU versus PIFU £4,480. The total number of patient miles that would have been travelled with HFU was 20,435 miles (mean 108.7miles/patient) as compared to 888 miles for PIFU (mean 4.7miles/patient). This resulted in an overall mean 94.7% cost saving per patient. Travelling time was also dramatically reduced for PIFU, 13 and 32 minutes/patient versus 293 and 700 minutes/patient for HFU, for travel by car and public transport respectively.
Conclusion The introduction of patient self-management follow up schemes for LREC can bring considerable financial and time savings to both the patient and the health care economy as compared to HFU.
Disclosure Nothing to disclose.
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