1530P - The mobile oncological service for out-patients (MOD): Analysis of cost effectiveness and quality of life in the first quarters of action

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Supportive Care
Bioethics, Legal, and Economic Issues
Presenter Ursula Vehling-Kaiser
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors U. Vehling-Kaiser1, T. Weiglein1, G. Damnali2, F. Kaiser1
  • 1Hematoonkology, Schwerpunktpraxis für Hämatologie, Onkologie und Palliativmedizin Praxis Dr. Vehling - Kaiser, 84028 - Landshut/DE
  • 2Hematoonkology, Praxis Vehling-Kaiser, 84028 - Landshut/DE

Abstract

Aim

The mobile oncological service for out-patients (MOD) is a project of the Oncologic-Palliative-Care-Network of Landshut, Germany. It was implemented to improve the medical care for multimorbid patients in remote rural areas, receiving oral or subcutaneous treatments at home. The delegation of doctoral tasks to especially trained staff on site is one of the crucial points. As a trend-setting project for rural areas lacking the infrastructure for complex cancer-patients, the MOD has been nominated for the Bavarian Health Award 2013. We present the first analyses of patient satisfaction and cost effectiveness of this novel service.

Methods

We prospectively collected data of all patients included into the MOD from August 2013 until March 2014. Patient's requirements for inclusion in the MOD were: oncological patient, poor general condition, lack of transportation means or increased danger of infection. For comparing costs of the MOD to alternative services necessary for reaching consultation, we calculated the standard rates of ambulance with or without professional attendance and regional cab fares. Patient satisfaction and quality of life (QOL) analyses were measured by a standardized questionnaire for patients visited at least ten times and included for at least three months into the MOD.

Results

A total of 62 patients were included with a median of five home visits per patient and quarter: costing 50 Euros per hour, the MOD service spent an average of 4,75 hours per patient and quarter, resulting in 237 Euros. Without MOD, a median of 142km would be necessary for five consultations at the practice per quarter and patient. Calculated costs of ambulance or cabs would range from 260 to 600 Euros for transportation alone, resulting in a 10-60% cost reduction by the MOD. Also, the QOL-questionnaires showed that 100% of all patients felt securer within their therapy, 100% of patients had improvement of QOL, and 80% had significant relief of strain within their families.

Conclusions

The MOD is a novel and unique service for cancer patients in rural Germany. Our preliminary results show that this service not only reduces costs for health care while improving patient safety, but also leads to a dramatic improvement of quality of life. We conclude that this service should be implemented into all rural areas facing these issues.

Disclosure

All authors have declared no conflicts of interest.