Resource utilization in lung cancer diagnostic procedures: Current use and budget consequences

Area of Science:

• Oncology
• Health Economics
• Clinical Practice Research

Background:

• Lung cancer diagnosis relies on established clinical practice guidelines (CPG).
• Variations in diagnostic procedure utilization exist across healthcare institutions.
• Understanding diagnostic work-up costs is crucial for healthcare management.

Purpose of the Study:

• To assess current lung cancer diagnostic procedures in two Dutch hospitals.
• To identify deviations in CPG adherence between these hospitals.
• To estimate the budget impact of diagnostic work-up, including over- and underutilization.

Main Methods:

• A state transition model was developed based on CPG and literature review.
• Diagnostic utilization data were collected from an academic tertiary care hospital and a regional teaching hospital.
• Patient data were sourced from the Netherlands cancer registry.

Main Results:

• The study included 376 lung cancer patients.
• Deviations from CPG were observed, such as MR brain usage in stage III lung cancer patients.
• The estimated budget impact per patient was €2496 in the academic hospital and €2191 in the regional hospital.

Conclusions:

• Hospital adherence to CPG for lung cancer diagnosis differs significantly.
• Inconsistent CPG adherence raises questions about general guideline compliance.
• Improved adherence to CPG has the potential to reduce diagnostic pathway costs.