Impact of Institutional Practices and Surgical Complexity on Sarcoma Surgery Costs: Driving Efficiency in Value-Based Healthcare
by
, , , , , and
Georg Schelling
1,2,
Philip Heesen
2,3,
Boris Tautermann
4,
Markus Wepf
5,
Barbara Di Federico
3,
Annika Frei
5,
Kim van Oudenaarde
1,2,
Pietro Giovanoli
3,
Beata Bode-Lesniewska
1,2,6,
Gabriela Studer
2,
Bruno Fuchs
2,*
and
on behalf of the Swiss Sarcoma Network
† 1
Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland
2
Sarcoma Center & Department of Orthopedics & Trauma, LUKS University Hospital, 6000 Lucerne, Switzerland
3
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
4
Klinik Hirslanden, St. Anna, 6000 Luzern, Switzerland
5
Sarkomzentrum KSW & Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, 8400 Winterthur, Switzerland
6
Pathologie Enge, Pathology Institute, 8031 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
†
Additional collaborators of the Swiss Sarcoma Network are indicated in the Acknowledgement.
Cancers 2024, 16(12), 2209; https://doi.org/10.3390/cancers16122209
Submission received: 13 May 2024
/
Revised: 10 June 2024
/
Accepted: 11 June 2024
/
Published: 13 June 2024
(This article belongs to the Section Clinical Research of Cancer)
Simple Summary
Sarcomas are rare cancers that are complex to treat and can be expensive to manage, especially when considering surgery costs. This research investigates how much sarcoma surgeries cost across three different hospitals in Switzerland and examines what factors might cause these costs to vary. By consistently using the same surgeon for all procedures, the study ensures that differences in surgical expertise do not affect the results, allowing a clear focus on hospital practices and the complexity of tumor impact costs. The findings aim to help hospitals better plan and manage resources, potentially leading to more cost-effective treatments. This study could influence how healthcare systems approach the financial aspects of treating complex cancers, encouraging a shift towards more standardized and economically sustainable practices.
Abstract
Background: Sarcomas present a unique challenge within healthcare systems due to their rarity and complex treatment requirements. This study explores the economic impact of sarcoma surgeries across three Swiss tertiary healthcare institutions, utilizing a consistent surgical approach by a single surgeon to eliminate variability in surgical expertise as a confounding factor. Methods: By analyzing data from 356 surgeries recorded in a real-world-time data warehouse, this study assesses surgical and hospital costs relative to institutional characteristics and surgical complexity. Results: Our findings reveal significant cost variations driven more by institutional resource management and pricing strategies than by surgical techniques. Surgical and total hospitalization costs were analyzed in relation to tumor dignity and complexity scores, showing that higher complexity and malignancy significantly increase costs. Interestingly, it was found that surgical costs accounted for only one-third of the total hospitalization costs, highlighting the substantial impact of non-surgical factors on the overall cost of care. Conclusions: The study underscores the need for standardized cost assessment practices and highlights the potential of predictive models in enhancing resource allocation and surgical planning. By advocating for value-based healthcare models and standardized treatment guidelines, this research contributes to more equitable and sustainable healthcare delivery for sarcoma patients. These insights affirm the necessity of including a full spectrum of care costs in value-based models to truly optimize healthcare delivery. These insights prompt a reevaluation of current policies and encourage further research across diverse geographical settings to refine cost management strategies in sarcoma treatment.
