Insurance status and time to completion of surgery for breast cancer

ANZ J Surg. 2016 Jan-Feb;86(1-2):84-7. doi: 10.1111/ans.13107. Epub 2015 Apr 19.

Abstract

Background: The aim of this study was to compare the time to re-operation, following inadequate loco-regional surgery for breast cancer, between the public and private sectors of the Sunshine Coast region.

Methods: A retrospective review was performed of the medical records of all female patients undergoing guide wire-localized, breast-conserving surgery at Nambour General Hospital and in the local private sector from January 2009 until April 2010. The dates of initial consultation, operation, post-operative consultation and any subsequent reoperation were recorded.

Results: One hundred and seventeen public sector patients and 113 private sector patients were identified during the study period. Thirty-seven public patients (32%) and 46 private patients (41%) required re-operation. This difference was not significant (χ(2) = 2.06, degrees of freedom (df) = 1, P = 0.15). The mean time and standard error from the initial consultation to the first operation and re-operation in the public sector was 26 (2.3) and 62 (3.8) days, and in the private sector was 12 (1.2) and 30 (4.4) days, respectively P < 0.001. On average, 70% of public patients and 96% of private patients completed the surgical component of their breast cancer management within the Queensland Health-recommended time frame of 30 days (χ(2) = 26, df = 1, P < 0.001).

Conclusion: While experiencing similar rates of re-operative surgery in breast cancer management in the public and private sectors, the private sector deals with this issue in a more time efficient manner. An opportunity for intervention by quarantining theatre time is explored to improve the public sector time management.

Keywords: adjuvant chemotherapy; breast cancer; breast-conserving surgery; health insurance; loco-regional treatment.

Publication types

  • Comparative Study

MeSH terms

  • Breast Neoplasms / economics*
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Chemotherapy, Adjuvant / methods
  • Female
  • Hospitals, Private / economics
  • Hospitals, Public / economics
  • Humans
  • Insurance Coverage / economics*
  • Insurance, Health / economics*
  • Mastectomy, Segmental / economics*
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Private Sector
  • Queensland
  • Reoperation / economics
  • Retrospective Studies
  • Time Factors*