PCN2 Cost-Effectiveness and Budget Impact Analysis of an Immediate Care Center at the National Cancer Institute, Mexico

To assess cost and clinical consequences (day of hospital stay avoided), together with a budget impact analysis and assess frequency of symptoms. Evaluation of Immediate Care Center records during September 2009. Data collected were: chief complaint, primary disease (oncologic), semiology, requested studies, percentage of hospitalized patients, days of hospital stay. We compared days of hospitalization related to the main symptoms cause of consultation in 2009 versus 2005 getting hospitalization days and costs avoided through a full economic study type analysis cost-effectiveness, retrospective, analytical, longitudinal with a design before and after comparing the effectiveness and efficiency of the implementation of a multidisciplinary service (medical oncologist, surgical oncologist, algologist, internist). A total of 583 records were analyzed. Breast cancer was the most common diagnosis (28%), pain as main symptom present (52%) and as a reason for consultation (31.82%). In semiology the most frequent causes of hospitalization in 2009 (with immediate care center) were: somatic pain, dyspnea and fever, these symptoms were compared with patients who require hospitalization for the same reason in September of 2005 (without immediate care center) noting a reduction of 9.08, 3.28 and 3.12 respectively on “days of hospital stay avoided.” The percentage of patients hospitalized for 2005 were 25.55% of 493 versus 10.46% of 583 patients during September of 2009. The stratified ICER for somatic pain was $ - 1615 MXN, - $1513 MXN for dyspnea, and - $1169 MXN for fever. We estimated an average monthly savings of $ 659,072.00 MXN pesos. The implementation of an immediate care service for cancer patient management through a comprehensive and multidisciplinary approach results in a highly cost – effectiveness measure in the resolution of symptoms, using timely and appropriate diagnostic and therapeutic tools with consequent decrease in hospitalization rates, reflecting“days of hospital stay avoided” adding an estimated annual budget impact of $ 7, 908, 860.00 MXN pesos.