Highlights
- •Full economic evaluation studies of quick diagnosis units (QDUs) are lacking.
- •There were notable cost savings from hospitalization in anemia and cancer patients.
- •Main health outcomes of QDU and hospitalization by cost-minimization were equivalent.
- •Highest QDU savings corresponded to fixed costs of hospital stays (66% of savings).
- •QDU savings from structural/general functioning costs of hospitalization were 33%.
Abstract
Background
Quick diagnosis units (QDUs) are a promising alternative to conventional hospitalization
for the diagnosis of suspected serious diseases, most commonly cancer and severe anemia.
Although QDUs are as effective as hospitalization in reaching a timely diagnosis,
a full economic evaluation comparing both approaches has not been reported.
Aims
To evaluate the costs of QDU vs. conventional hospitalization for the diagnosis of
cancer and anemia using a cost-minimization analysis on the proven assumption that
health outcomes of both approaches were equivalent.
Methods
Patients referred to the QDU of Bellvitge University Hospital of Barcelona over 51
months with a final diagnosis of severe anemia (unrelated to malignancy), lymphoma,
and lung cancer were compared with patients hospitalized for workup with the same
diagnoses. The total cost per patient until diagnosis was analyzed. Direct and non-direct
costs of QDU and hospitalization were compared.
Results
Time to diagnosis in QDU patients (n=195) and length-of-stay in hospitalized patients (n=237) were equivalent. There were considerable costs savings from hospitalization.
Highest savings for the three groups were related to fixed direct costs of hospital
stays (66% of total savings). Savings related to fixed non-direct costs of structural
and general functioning were 33% of total savings. Savings related to variable direct
costs of investigations were 1% of total savings. Overall savings from hospitalization
of all patients were €867,719.31.
Conclusion
QDUs appear to be a cost-effective resource for avoiding unnecessary hospitalization
in patients with anemia and cancer. Internists, hospital executives, and healthcare
authorities should consider establishing this model elsewhere.
Keywords
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Article info
Publication history
Published online: March 01, 2016
Accepted:
December 18,
2015
Received in revised form:
December 17,
2015
Received:
September 3,
2015
Identification
Copyright
© 2016 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
