Saving costs through a coordinated care model for patients with hepatocellular cancer.

Background: In keeping with recent trends, patients with hepatocellular cancer have had their care managed by a dedicated Nurse Coordinator at our tertiary Australian hospital since 2010. To date, there are few data to justify the cost-effectiveness of this approach.

Aims: To quantify the potential cost saved through the employment of a Nurse Coordinator in the management of patients with hepatocellular carcinoma at a single tertiary-level Australian hospital.

Methods: A retrospective audit of patients managed by the Nurse Coordinator between 2010 and 2015 was conducted. Consensus reports from previous meetings were reviewed, and nurse-initiated radiological procedures and encounters were identified. Clinical activities were prospectively evaluated over a 1-month period in July-August 2015. The equivalent annual number of outpatient medical encounters spared was calculated. Using the national average cost of each gastroenterology outpatient encounter, a total annual cost was determined and was compared against the cost of funding the position.

Results: The activity of the Nurse Coordinator resulted in an equivalent of at least 175 outpatient encounters being spared per year, with a minimum annual cost saving of $85 750. A total of 113 encounters resulted from the independent delivery and initiation of multidisciplinary team meeting plans; 10 were attributed to nurse-led patient education, and 52 were equated to weekly clinical activities. This represented a net annual saving of $17 050.

Conclusion: The incorporation of the Nurse Coordinator in the care pathway of patients with hepatocellular cancer is associated with a reduction in medical outpatient load and, consequently, a significant annual cost saving.