Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Promoting equitable access to specialist head and neck cancer surgical services in regional NSW: cost savings to patients and the health system through provision of outreach clinics (#125)

Rebecca L Venchiarutti 1 2 , Alison Pearce 2 3 , Lara Mathers 1 , Tania Dawson 1 , Sydney Ch'ng 1 4 5 6 , Kerwin Shannon 1 , Jonathan R Clark 1 4 5 , Carsten E Palme 1 4 5
  1. Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
  2. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  3. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  4. Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia
  5. Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  6. Department of Plastic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

Aim:

Access to head and neck cancer (HNC) surgical services in regional and remote Australia is limited, resulting in patients needing to travel long distances for consultations and treatment. Outreach clinics offer a model of care that allows diagnostic and follow-up services to be offered locally. The aim of this study was to estimate cost savings to patients and the health system through provision of outreach clinics.

 

Methods:

Three outreach clinics offered through the Chris O’Brien Lifehouse (COBLH) in regional NSW were retrospectively audited over a four-year period. Under various assumptions, direct costs of transport and accommodation were estimated based on distance between i) the patient’s residence and the patient’s regional clinic and ii) the patient’s regional clinic and the COBLH in Sydney. Reimbursement through government travel support schemes were also estimated. Results are presented as descriptive statistics and costs reported in 2022 Australian dollars.

 

Results:

A total of 657 patients attended the three clinics over the study period accounting for 1,981 appointments. Depending on mode of travel, median cost of return travel to Sydney per appointment ranged from $379 to $739 per patient, and government reimbursements ranged from $182 to $279. In contrast, cost of return travel to local regional clinics ranged from $28 to $163 per appointment. Provision of regional clinics was estimated to save patients a median of $285 per trip and avoided government reimbursements of $215 per trip, totalling $570,000 and $335,000 respectively over the four-year audit.

 

Conclusions: Outreach clinics for HNC surgical services result in significant savings to patients and the health system. Investment in this model of care can improve access to value-based, high-quality care that optimises patient outcomes. Governments could reinvest costs saved by avoiding reimbursement for travel into regional capacity building to strengthen access to specialist services.