Original articleGeneral thoracicThe Effects of a Multidisciplinary Care Conference on the Quality and Cost of Care for Lung Cancer Patients
Section snippets
Patients and Methods
This study was designed as a retrospective cohort analysis. The St. Vincent Hospital Institutional Review Board approved the study, and individual patient consent was not required with the condition of patient anonymity outside the initial data-gathering phase of the study. The Premier inpatient database (Premier Inc, Charlotte, NC) was used to identify patients diagnosed with NSCLC (International Classification of Diseases, Ninth Revision [ICD-9] diagnosis codes 162.2, 162.3, 162.4, 162.5,
Results
During the 6-year study period, 15,731 patients with NSCLC were identified at 49 hospitals in 26 states that met the entrance criteria for this investigation. After a determination of whether identified treatment facilities did or did not have an MDC that met this investigation’s criteria, 6,627 patients met the patient and facility inclusion criteria for the MDC cohort from 27 hospitals. These MDC patients were propensity matched, as previously described, to 6,627 patients who met the patient
Comment
Several investigations have outlined the benefits of a prospective, MDC for the evaluation and treatment planning of patients with malignancy. In a 2009 report, our group found that an MDC significantly increased the percentage of patients receiving complete staging, a multidisciplinary evaluation, and adherence to nationally accepted care guidelines while decreasing the interval from diagnosis to treatment in patients with NSCLC cancer [10]. We reported similar findings for patients with
References (16)
- et al.
The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with esophageal cancer
Ann Thorac Surg
(2011) - et al.
Is it worth reorganizing cancer services on the basis of multidisciplinary teams? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes
Health Policy
(2015) Risk adjustment for measuring health care outcomes
(2003)- et al.
Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data
Med Care
(2005) Causality: models, reasoning, and inference, Second edition
(2009)Reducing bias in a propensity score matched-pair sample using greedy matching techniques. Proceedings of the 26th Annual SAS Users Group International Conference
(2001)- et al.
Hierarchical linear models, advanced quantitative techniques in the social sciences
(1992)
Cited by (38)
Unreimbursed Costs of Multidisciplinary Conferences to a Radiology Department: A Prospective Analysis at an Academic Medical Center
2024, Journal of the American College of RadiologyDoes Multidisciplinary Team Management Improve Clinical Outcomes in NSCLC? A Systematic Review With Meta-Analysis
2023, JTO Clinical and Research ReportsAssociations between healthcare costs and care experiences among older adults with and without cancer
2023, Journal of Geriatric OncologyTime to diagnosis and treatment of lung cancer: A systematic overview of risk factors, interventions and impact on patient outcomes
2022, Lung CancerCitation Excerpt :Factors with non-significant or inconsistent associations were hospital volume [22] and surgery [24,28]. Interventions aimed at reducing the times to diagnosis and treatment are summarised in Table 4 [21,22,26,27,30–32,34,35], including the basic characteristics of the original studies with statistically positive results (all on the intervals between first presentation to treatment initiation) [64,68,73–84]. Three reviews found positive results in studies on patient navigation programs [22,30,35], including implementation of an oncological nurse navigator [22,35,83,84] and program for care coordination (“Cancer Care Coordination Program” (CCCP) at a US hospital) [30,35,64].
A scoping review of the economics of multidisciplinary teams in oncology care
2020, Journal of Cancer PolicyCitation Excerpt :In addition to the time costs of members prior to and during MDTs, complete MDT costings should include the costs of hosting the MDT, the costs of any additional investigations ordered prior to the MDT and any differences in post-MDT health care costs. The majority of studies (67 %) provided cost or resource estimates for hosting an MDT [25,26,28–31,34,35,37,39], one reported the total national cost to the government of providing reimbursements for MDTs [36] and four reported on the impact of an MDT on subsequent patient hospital costs [27,32,33,38] (see Table 3). Studies that evaluated the cost or resource use of MDTs most often presented the cost per MDT meeting, the cost per patient or case discussed, or the time per case discussed.
Timeliness of access to lung cancer diagnosis and treatment: A scoping literature review
2017, Lung CancerCitation Excerpt :Sample sizes ranged from 8 to 56,624 patients with a median of 309. The majority of studies (75%) were retrospective and obtained data from chart reviews or cancer registries (Table 1) [12–76]. The main findings, detailed in this section, consist of 1) variation in both measurement of wait-time and in measured wait-time intervals, 2) associations between wait-time and survival, healthcare utilization, costs, and patient characteristics, and 3) effect of interventions on wait-time.