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Cost analysis of nurse-lead telephone follow-ups after benign hysterectomy: a randomized, single-blinded, four-arm, controlled multicenter trial
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Övr Regionledningskontoret. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.ORCID iD: 0000-0002-3730-7722
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2025 (English)In: Archives of Gynecology and Obstetrics, ISSN 0932-0067, E-ISSN 1432-0711, Vol. 312, no 2, p. 515-523Article in journal (Refereed) Published
Abstract [en]

PurposeThe aim of the study was to evaluate the health economics of nurse-led telephone follow-up contacts (TFUs) within six weeks after benign hysterectomy in a societal perspective, using a cost minimization analysis model.MethodsA randomized, single-blinded, controlled, Swedish multicenter study comprising 487 women undergoing benign hysterectomy. The women were allocated 1:1:1:1 to either Group A (no TFUs), Group B (one clinically structured TFU the day after discharge), Group C (as B, but with additional TFUs once weekly for six weeks, in total six TFUs), or Group D (as C, but by applying a coaching technique). Time consumption for planned TFUs, informal care, and the number of unplanned telephone contacts and visits were recorded. Costs were assessed using a cost-per-patient price list for Link & ouml;ping University Hospital.ResultsThe total cost per patient more than doubled in the groups with repeated TFUs (Groups C and D) compared with no TFUs (Group A). Group D demonstrated fewer unplanned telephone contacts and lower informal care costs. Group B, with only one TFU, exhibited the highest time consumption for TFU. The additional costs of six TFUs, with or without coaching, substantially increased the costs. The coaching TFU group (Group D) had the lowest cost for informal care.ConclusionTFUs appeared to be costly and an inefficient way of using healthcare resources after benign hysterectomy. The coaching TFU seemed to reduce unplanned telephone contacts and lower informal care costs. Careful consideration of the costs and the impact on clinical outcomes is important before implementing TFU after surgery.Trial registrationThis study is registered retrospectively in ClinicalTrial.gov: NCT01526668 on January 27, 2012. Date of enrollment of first patient: October 11; 2011.

Place, publisher, year, edition, pages
SPRINGER HEIDELBERG , 2025. Vol. 312, no 2, p. 515-523
Keywords [en]
Hysterectomy; Telephone follow-up; Cost minimization analysis; Healthcare; Patient-centered care
National Category
Gynaecology, Obstetrics and Reproductive Medicine
Identifiers
URN: urn:nbn:se:liu:diva-213565DOI: 10.1007/s00404-025-08035-1ISI: 001480165500001PubMedID: 40314809Scopus ID: 2-s2.0-105003948036OAI: oai:DiVA.org:liu-213565DiVA, id: diva2:1958168
Note

Funding Agencies|Linkoping University; Medical Research Council of Southeast Sweden [FORSS-155141, FORSS-222211, FORSS-308441, FORSS-387761]; Futurum-the Academy of Health and Care, Region Jonkoping Council [FUTURUM-487481, FUTURUM 579171]

Available from: 2025-05-14 Created: 2025-05-14 Last updated: 2025-10-23Bibliographically approved

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Kassymova, GulnaraDavidson, ThomasSydsjö, GunillaBorendal Wodlin, NinnieNilsson, LenaKjölhede, Preben

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Kassymova, GulnaraDavidson, ThomasSydsjö, GunillaBorendal Wodlin, NinnieNilsson, LenaKjölhede, Preben
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Division of Children's and Women's HealthFaculty of Medicine and Health SciencesDepartment of Gynaecology and Obstetrics in LinköpingDivision of Society and HealthÖvr RegionledningskontoretDivision of Clinical Chemistry and PharmacologyANOPIVA US
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