TY - JOUR

T1 - Determinants of variable resource use for multidisciplinary team meetings in cancer care

AU - Alexandersson, Nathalie

AU - Rosell, Linn

AU - Wihl, Jessica

AU - Ohlsson, Björn

AU - Steen Carlsson, Katarina

AU - Nilbert, Mef

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Multidisciplinary team meetings (MDTMs) have developed into standard of care to provide expert opinion and to grant evidence-based recommendations on diagnostics and treatment of cancer. Though MDTMs are associated with a range of benefits, a growing number of cases, complex case discussion and an increasing number of participants raise questions on cost versus benefit. We aimed to determine cost of MDTMs and to define determinants hereof based on observations in Swedish cancer care.METHODS: Data were collected through observations of 50 MDTMs and from questionnaire data from 206 health professionals that participated in these meetings.RESULTS: The MDTMs lasted mean 0.88 h and managed mean 12.6 cases with mean 4.2 min per case. Participants were mean 8.2 physicians and 2.9 nurses/other health professionals. Besides the number of cases discussed, meeting duration was also influenced by cancer diagnosis, hospital type and use of video facilities. When preparatory work, participation and post-MDTM work were considered, physicians spent mean 4.1 h per meeting. The cost per case discussion was mean 212 (range 91-595) EUR and the cost per MDTM was mean 2675 (range 1439-4070) EUR.CONCLUSIONS: We identify considerable variability in resource use for MDTMs in cancer care and demonstrate that 84% of the total cost is derived from physician time. The variability demonstrated underscores the need for regular and structured evaluations to ensure cost effective MDTM services.

AB - BACKGROUND: Multidisciplinary team meetings (MDTMs) have developed into standard of care to provide expert opinion and to grant evidence-based recommendations on diagnostics and treatment of cancer. Though MDTMs are associated with a range of benefits, a growing number of cases, complex case discussion and an increasing number of participants raise questions on cost versus benefit. We aimed to determine cost of MDTMs and to define determinants hereof based on observations in Swedish cancer care.METHODS: Data were collected through observations of 50 MDTMs and from questionnaire data from 206 health professionals that participated in these meetings.RESULTS: The MDTMs lasted mean 0.88 h and managed mean 12.6 cases with mean 4.2 min per case. Participants were mean 8.2 physicians and 2.9 nurses/other health professionals. Besides the number of cases discussed, meeting duration was also influenced by cancer diagnosis, hospital type and use of video facilities. When preparatory work, participation and post-MDTM work were considered, physicians spent mean 4.1 h per meeting. The cost per case discussion was mean 212 (range 91-595) EUR and the cost per MDTM was mean 2675 (range 1439-4070) EUR.CONCLUSIONS: We identify considerable variability in resource use for MDTMs in cancer care and demonstrate that 84% of the total cost is derived from physician time. The variability demonstrated underscores the need for regular and structured evaluations to ensure cost effective MDTM services.

KW - Group Processes

KW - Humans

KW - Neoplasms

KW - Patient Care Team/economics

KW - Physicians

KW - Sweden

U2 - 10.1080/0284186X.2017.1400682

DO - 10.1080/0284186X.2017.1400682

M3 - Journal article

C2 - 29199517

VL - 57

SP - 675

EP - 680

JO - Acta Oncologica

JF - Acta Oncologica

SN - 1100-1704

IS - 5

ER -