Resource implications of bilateral autologous breast reconstruction--a single centre's seven year experience

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
A R MolinaC M Malata

Abstract

Since the recent introduction of ''Payment by Results'' as part of NHS financial reforms, it has been noted that there is an imbalance between allocated Healthcare Resource Group tariffs and actual resource use for certain procedures. This study was undertaken to assess the impression that bilateral breast reconstruction using autologous flaps is under-funded. Patients who underwent bilateral flap breast reconstruction following mastectomy between 2000 and 2006 at Addenbrooke's University Hospital were identified. Resource cost analysis for each patient was based on the following parameters: number of operating consultants, theatre running costs, and length of hospital stay. The estimated hospital costs were then compared to the national tariff for the Healthcare Resource Group ''Complex Breast Reconstruction using Flaps''. Over the 7-year period 24 patients underwent bilateral flap breast reconstruction (7 paired latissimus dorsi and 17 paired abdominal flaps). The mean operative time was 9.4h (£4.5/min), the mean hospital stay was 10 days (£150/day) and ten patients required 2 consultants (£34/h) operating. The average total cost equated to £5 492. The allocated tariff of £4 053 is insufficient, even before the inclusion of h...Continue Reading

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Citations

Mar 20, 2013·Plastic and Reconstructive Surgery·Natalia I ZiolkowskiAchilleas Thoma
Nov 11, 2015·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S A RobertsonR M Rainsbury
Jan 15, 2013·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·O LotterP Jaminet
May 16, 2013·ANZ Journal of Surgery·Shiba SinhaWayne Morrison
Aug 26, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·K MiyagiC M Malata

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