cost-analysis and patient experience of a one-stop bariatric clinic david bunting ian finlay
Post on 31-Mar-2015
222 Views
Preview:
TRANSCRIPT
Cost-analysis and patient experience of a one-stop bariatric
clinic David Bunting
Ian Finlay
Background
• Royal Cornwall Hospital
• Single bariatric centre in Cornwall
• Resident population 535,300*
• Sparsely populated
*Office of National Statistics mid year estimate 2010
Office of National Statistics
Background – NICE Guidance
NICE Guidance
• ‘all appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months’
• Consultations prior to considering surgery– Endocrinologist– Dietician– Exercise therapist
Background
• Care should be within a multidisciplinary team
• One-stop clinic developed
• Consultations required before decision on surgery– Dietician– Anaesthetist – Surgeon
Background
• Free on-site parking
• Three separate consulting rooms
• Afternoon appointments
• Prior to decision regarding suitability for surgery
Study aims
• Patient views/satisfaction
• Strengths and weaknesses
• Identify savings compared to three-stop clinic – travelling time – travelling distance– cost of travel
Methods
• 1 year period
• Patient survey– 10-point visual analogue scale– tick-boxes – free-text boxes
• Travelling distances and times recorded
• Travel cost estimated
• Savings calculated
Results
• 29/46 patients responded (63%)
Duration of appointment
Usefulness of appointment
Efficiency of clinic
Ease of getting to clinic
Journey distance one-way
Journey times – one way
Results
• Distance travelled– Average 23.3 miles one-way
• Travel time– Average 1hr 36 minutes one-way
• Travel cost– Average £9.31
Results
• Travel distance saved– 93 miles per patient (up to 228 miles)
• Travel time saved– 3 hours 13 minutes per patient (up to 10
hours)
• Travel cost saving– £37.20 (up to £91.20)
Waited longer than expected
Waited longer than necessary
Prefer one-stop clinic
Patient comments
• Not enough information on post-operative diet
• Decision regarding suitability for surgery not made on the day
• Long distance to clinic
• Travelling time
Patient comments
• On-site free parking
• Friendliness of staff
• Not made to feel guilty
• Not rushed
• Put at ease
• Good information/advice given
Limitations
• Response rate– sampling bias
• Survey delivered by hospital– positive satisfaction bias
Conclusions
• One-stop clinic– Feasible– Acceptable to patients– Considerable reductions in travelling distance
and times
• Inform patients prior to clinic– Process can take up to 3 hours– Decision regarding surgery not made instantly
Acknowledgements
• Bariatric team– Surgeons– Dieticians– Anaesthetists– Bariatric secretary– Bariatric nurse specialist
• Patients
top related