PEDIATRICS Vol. 66 No. 6 December 1980, pp. 907-911
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Cost-Effectiveness of a Shared-Management Delivery System for the Care of Children with Cancer

Faye Strayer PhD1, C. Thomas Kisker MD1, and Carol Fethke PhD1

1 Department of Pediatrics, The University of Iowa, Iowa City

Costs of two alternative methods for obtaining comparable quality outpatient care for pediatric cancer patients were examined. Costs incurred in obtaining care from specialists, "specialist-management," were compared to costs incurred in obtaining "shared-management," care provided by specialists and primary physicians combined. Shared-management medical costs for outpatient care were 10% less than they would have been had the care been obtained from specialists. The nonmedical costs of transportation, parking, food away from home, and lost productivity or income were all less under the shared-management medical care delivery system than they would have been had specialist management been utilized. The total estimated cost differences between the alternative systems for the delivery of outpatient care ($2,191.34) represents for shared management a mean saving per patient of approximately 29% in direct out-of-pocket expenses and a 59% savings in the indirect costs of lost income or productivity. A total theoretical mean 41% saving per patient was shown to accrue through the use of shared management.

Submitted on October 10, 1979
Accepted on April 29, 1980