Real world financial benefits of outpatient bladder cancer management using a dual-diode laser
BAUS ePoster online library. Syed H. 11/10/20; 304242; P11-12
Ms. Hira Syed
Ms. Hira Syed
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Real world financial benefits of outpatient bladder cancer management using a dual-diode laser

Syed H1, Aljoe J1, Walters U3, Bedi N2, Gan C2, James P1, Shamsuddin A2, Agrawal S1
1Ashford and St Peters Hospitals NHS Foundation Trust, United Kingdom, 2Imperial NHS Trust, Urology, London, United Kingdom, 3Northwick Park Hospital, London, United Kingdom

Introduction:
Bladder cancer is the eleventh most common cancer with over 40,000 cases treated per year in the UK. TURBT remains the gold standard, however outpatient based transurethral laser ablation (TULA) has similar outcomes in low/intermediate grade disease in select cohorts. We analysed the financial benefit for patients treated to date.

Methods:
A prospective database of all patients undergoing TULA from 3 NHS Trusts was reviewed. Potential benefit between TULA and TURBT was made analysing tariffs, bed days and opportunity costs.

Results:
Between 2014-2019, 475 patients underwent 990 TULA procedures. The 2016/17 tariff for TURBT was £1608 compared to £979 for TULA, resulting in a £622,710 saving to the CCGs. TURBT is often loss leading for a Trust. Average procedure times were TURBT (90 min) and TULA (30min). With the average hourly cost of theatre time estimated at £940 this potentially has saved Trusts £1,395,900 and cleared 124 operative days (based on 8 cases/day). All TULA cases were outpatient based with no admissions. National TURBT average length of stay is 1.6 days thus saving up to 760 bed days. Each day costing £222, equating to a £351,648 saving. Costs of TULA need to be offset against this and are £108/hr (8 cases/session £432) overall costing £53,568 across the 990 procedures.

Conclusion:
Along with patient benefits, the financial benefit of TULA is multifaceted. Resulting in savings for NHS Trusts/CCGs whilst alleviating bed pressures and 'creating' theatre capacity.
Real world financial benefits of outpatient bladder cancer management using a dual-diode laser

Syed H1, Aljoe J1, Walters U3, Bedi N2, Gan C2, James P1, Shamsuddin A2, Agrawal S1
1Ashford and St Peters Hospitals NHS Foundation Trust, United Kingdom, 2Imperial NHS Trust, Urology, London, United Kingdom, 3Northwick Park Hospital, London, United Kingdom

Introduction:
Bladder cancer is the eleventh most common cancer with over 40,000 cases treated per year in the UK. TURBT remains the gold standard, however outpatient based transurethral laser ablation (TULA) has similar outcomes in low/intermediate grade disease in select cohorts. We analysed the financial benefit for patients treated to date.

Methods:
A prospective database of all patients undergoing TULA from 3 NHS Trusts was reviewed. Potential benefit between TULA and TURBT was made analysing tariffs, bed days and opportunity costs.

Results:
Between 2014-2019, 475 patients underwent 990 TULA procedures. The 2016/17 tariff for TURBT was £1608 compared to £979 for TULA, resulting in a £622,710 saving to the CCGs. TURBT is often loss leading for a Trust. Average procedure times were TURBT (90 min) and TULA (30min). With the average hourly cost of theatre time estimated at £940 this potentially has saved Trusts £1,395,900 and cleared 124 operative days (based on 8 cases/day). All TULA cases were outpatient based with no admissions. National TURBT average length of stay is 1.6 days thus saving up to 760 bed days. Each day costing £222, equating to a £351,648 saving. Costs of TULA need to be offset against this and are £108/hr (8 cases/session £432) overall costing £53,568 across the 990 procedures.

Conclusion:
Along with patient benefits, the financial benefit of TULA is multifaceted. Resulting in savings for NHS Trusts/CCGs whilst alleviating bed pressures and 'creating' theatre capacity.
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