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A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology
BACKGROUND: The benefits of multidisciplinary working in oncology are now accepted as the norm and widely accepted as being pivotal to the delivery of optimal cancer care. Central to this are the multidisciplinary meetings (MDMs) and we have evaluated decision outcomes and financial costs of these....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817328/ https://www.ncbi.nlm.nih.gov/pubmed/24084764 http://dx.doi.org/10.1038/bjc.2013.586 |
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author | De Ieso, P B Coward, J I Letsa, I Schick, U Nandhabalan, M Frentzas, S Gore, M E |
author_facet | De Ieso, P B Coward, J I Letsa, I Schick, U Nandhabalan, M Frentzas, S Gore, M E |
author_sort | De Ieso, P B |
collection | PubMed |
description | BACKGROUND: The benefits of multidisciplinary working in oncology are now accepted as the norm and widely accepted as being pivotal to the delivery of optimal cancer care. Central to this are the multidisciplinary meetings (MDMs) and we have evaluated decision outcomes and financial costs of these. METHODS: We reviewed the electronic patient records of 551 newly referred patients, discussed at 14 tumour site-specific MDMs for adult solid tumours and lymphoma (paediatric oncology and acute leukaemia were excluded) over a 1-month period, a total of 52 MDMs were studied. In addition, the records of a further 81 patients from 10 different MDMs were reviewed where the treating consultant had clearly recorded their opinion of how the patient should be managed and this was compared with the final MDM's consensus view. We also costed the MDMs utilising two different methodologies. RESULTS: The mean age of the 551 patients in the study was 62 years. In all, 536 (97.3%) patients were treatment naive before MDM discussion and 15 (2.7%) had prior treatment. Median time to treatment after the MDM was 16 days. In 535 (97.1%) cases, the MDM discussions were clearly documented, 16 (2.9%) were not clearly documented. In total, 319 (57.9%) patients were discussed once, and 232 (42.1%) were re-discussed (one to six occasions). In 62 (12.7%) patients, there were delays in MDM discussion, 30 (48.4%) were related to radiology, 26 (41.9%) to histopathology and 6 (9.7%) a combination of both. Adherence to the MDM management plan decision occurred 503 times (91.3%) with 48 (8.7%) deviations. In the smaller cohort of 81 patients, the consultant management plan and MDM consensus was compatible 71 (87.6%) times. On four occasions, there were major alterations in management while six were minor. The cost per month of our MDMs ranged from £2192 to £10 050 (median £5136) with total cost of £80 850 per month and the cost per new patient discussed was £415. CONCLUSION: Adherence to MDM decisions by health-care professionals occurs in the majority of patients. MDMs are costly, which may have relevance in the currently challenged health-care financial environment. There is a need to improve MDM efficiency without losing the considerable benefits associated with regular MDMs. |
format | Online Article Text |
id | pubmed-3817328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-38173282014-10-29 A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology De Ieso, P B Coward, J I Letsa, I Schick, U Nandhabalan, M Frentzas, S Gore, M E Br J Cancer Clinical Study BACKGROUND: The benefits of multidisciplinary working in oncology are now accepted as the norm and widely accepted as being pivotal to the delivery of optimal cancer care. Central to this are the multidisciplinary meetings (MDMs) and we have evaluated decision outcomes and financial costs of these. METHODS: We reviewed the electronic patient records of 551 newly referred patients, discussed at 14 tumour site-specific MDMs for adult solid tumours and lymphoma (paediatric oncology and acute leukaemia were excluded) over a 1-month period, a total of 52 MDMs were studied. In addition, the records of a further 81 patients from 10 different MDMs were reviewed where the treating consultant had clearly recorded their opinion of how the patient should be managed and this was compared with the final MDM's consensus view. We also costed the MDMs utilising two different methodologies. RESULTS: The mean age of the 551 patients in the study was 62 years. In all, 536 (97.3%) patients were treatment naive before MDM discussion and 15 (2.7%) had prior treatment. Median time to treatment after the MDM was 16 days. In 535 (97.1%) cases, the MDM discussions were clearly documented, 16 (2.9%) were not clearly documented. In total, 319 (57.9%) patients were discussed once, and 232 (42.1%) were re-discussed (one to six occasions). In 62 (12.7%) patients, there were delays in MDM discussion, 30 (48.4%) were related to radiology, 26 (41.9%) to histopathology and 6 (9.7%) a combination of both. Adherence to the MDM management plan decision occurred 503 times (91.3%) with 48 (8.7%) deviations. In the smaller cohort of 81 patients, the consultant management plan and MDM consensus was compatible 71 (87.6%) times. On four occasions, there were major alterations in management while six were minor. The cost per month of our MDMs ranged from £2192 to £10 050 (median £5136) with total cost of £80 850 per month and the cost per new patient discussed was £415. CONCLUSION: Adherence to MDM decisions by health-care professionals occurs in the majority of patients. MDMs are costly, which may have relevance in the currently challenged health-care financial environment. There is a need to improve MDM efficiency without losing the considerable benefits associated with regular MDMs. Nature Publishing Group 2013-10-29 2013-10-01 /pmc/articles/PMC3817328/ /pubmed/24084764 http://dx.doi.org/10.1038/bjc.2013.586 Text en Copyright © 2013 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/ |
spellingShingle | Clinical Study De Ieso, P B Coward, J I Letsa, I Schick, U Nandhabalan, M Frentzas, S Gore, M E A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title | A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title_full | A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title_fullStr | A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title_full_unstemmed | A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title_short | A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology |
title_sort | study of the decision outcomes and financial costs of multidisciplinary team meetings (mdms) in oncology |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817328/ https://www.ncbi.nlm.nih.gov/pubmed/24084764 http://dx.doi.org/10.1038/bjc.2013.586 |
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