Fast-track access to urologic care for patients with macroscopic haematuria is efficient and cost-effective: results from a prospective intervention study

Br J Cancer. 2016 Sep 27;115(7):770-5. doi: 10.1038/bjc.2016.265. Epub 2016 Aug 25.

Abstract

Background: The delay between onset of macroscopic haematuria and diagnosis of bladder cancer is often long.

Methods: We evaluated timely diagnosis and health-care costs for patients with macroscopic haematuria given fast-track access to diagnostics. During a 15-month period, a telephone hotline for fast-track diagnostics was provided in nine Swedish municipalities for patients aged ⩾50 years with macroscopic haematuria. The control group comprised 101 patients diagnosed with bladder cancer in the same catchment area with macroscopic haematuria who underwent regular diagnostic process.

Results: In all 275 patients who called 'the Red Phone' hotline were investigated, and 47 of them (17%) were diagnosed with cancer and 36 of those had bladder cancer. Median time from patient-reported haematuria to diagnosis was 29 (interquartile range (IQR) 14-104) days and 50 (IQR 27-165) days in the intervention and the control group, respectively (P=0.03). The median health-care costs were lower in the intervention group (655 (IQR 655-655) EUR) than in the control group (767 (IQR 490-1096) EUR) (P=0.002).

Conclusions: Direct access to urologic expertise and fast-track diagnostics is motivated for patients with macroscopic haematuria to reduce diagnostic intervals and lower health-care expenditures.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catchment Area, Health
  • Cost-Benefit Analysis
  • Creatinine / blood
  • Cystoscopy
  • Delayed Diagnosis / economics
  • Early Detection of Cancer* / economics
  • Early Medical Intervention* / economics
  • Female
  • Health Care Costs
  • Hematuria / diagnosis*
  • Hematuria / economics
  • Hematuria / etiology
  • Hematuria / nursing
  • Hotlines*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Program Evaluation
  • Prospective Studies
  • Referral and Consultation
  • Sweden / epidemiology
  • Time-to-Treatment*
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / economics
  • Urinary Bladder Neoplasms / epidemiology
  • Urinary Bladder Neoplasms / surgery
  • Urology / organization & administration*

Substances

  • Creatinine