Comparing the costs of surveillance of early breast cancer by digital or traditional follow-up methods: a randomized cross-over study
ABSTRACT
Background:
An increasing number of early-stage breast cancer (EBC) survivors and limited healthcare resources have raised interest in developing digital methods for communication between patients and healthcare personnel. In 2015, Helsinki University hospital Comprehensive Cancer Center (HUS CCC) launched for cancer patients a digital solution, that allows patients to report their symptoms or side effects and ask questions with a computer or smart mobile device.
Objective:
In this study, we compare the cost and contacts of surveillance of EBC by two follow-up methods: digital solution and phone calls during their first year of follow-up outside pre-planned visits.
Methods:
After postoperative radiotherapy patients with EBC were randomized to surveillance with either a digital solution or phone calls in addition to routine follow-up visits. After six months the patient switched to the alternative follow-up method. Hospital contacts and the costs of specialized health care were extracted from the Ecomed database of the Helsinki and Uusimaa Hospital District. The Ecomed database records all hospital costs. The costs of follow-up visits and diagnostics at the Helsinki University Hospital Comprehensive Cancer Center were analyzed in a repeated measurements general linear model analysis.
Results:
Of 765 patients, 734 were included in the final analyses. There were no statistically significant differences in the number of outpatient visits or costs between the two follow-up methods or randomization arms. The number of visits and costs were higher during the latter follow-up period, probably due to the scheduled routine one year visit. There were more visits, and costs were higher in the digital solution group during the first 6 months, but higher in the phone call group during the latter 6-month period.
Conclusions:
We did not find any statistically significant differences in the total cost of follow-up of EBC by digital solution or phone calls. The digital solution may enable a faster access to outpatient services than conventional follow-up. Clinical Trial: ClinicalTrials.gov number: NCT04980989
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