Journal Information
Vol. 20. Issue 4.
Pages 273-279 (July - August 2006)
Vol. 20. Issue 4.
Pages 273-279 (July - August 2006)
Originales
Open Access
Coste por proceso en el tratamiento quirúrgico del cáncer de piel
Cost per episode of care in the surgical treatment of skin cancer
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1110
Ángela Hernández Martína,
Corresponding author
dermicus@yahoo.es

Correspondencia: Dra. Ángela Hernández Martín. Diego de Losada, 3, 6.°. 49018 Zamora. España.
, Antonio Núñez Reizb, Marta Sáiz Martínezc, Juan Rovirosa I Juncosad
a Unidad de Dermatología, Complejo Hospitalario de Burgos, Burgos, España
b Servicio de Informática, Complejo Hospitalario de Burgos, Burgos, España
c Enfermería del Área Quirúrgica, Complejo Hospitalario de Burgos, Burgos, España
d Dirección Gerencia, Complejo Hospitalario de Burgos, Burgos. España
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Abstract
Bibliography
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Resumen
Antecedentes

El cáncer cutáneo es la neoplasia maligna más frecuente en humanos. Su tratamiento puede ser efectuado con diversas técnicas y por diferentes especialistas, y la escisión quirúrgica es el método terapéutico con menor tasa de recidivas.

Objetivos

Evaluar el coste por proceso del tratamiento quirúrgico del cáncer cutáneo no melanoma (CCNM) cuando es realizado por un servicio de dermatología.

Material y método

Definición del proceso asistencial como conjunto de actividades clínicas que conducen al tratamiento quirúrgico del CCNM por parte de un especialista en dermatología, y cálculo del coste por proceso empleando los datos económicos facilitados por la institución sanitaria pública en que se ha realizado el análisis.

Resultados

El gasto por proceso varió entre 273,71 y 1.129,84 euros, dependiendo del procedimiento quirúrgico y de los recursos sanitarios empleados.

Conclusiones

El cáncer cutáneo es una de las enfermedades dermatológicas cuyo aspecto clínico suele ser inequívoco para los dermatólogos, por lo que muchas veces ni siquiera se precisa una confirmación histológica para diagnosticarlo y decidir la pauta terapéutica correspondiente. Este hecho hace que los dermatólogos quirúrgicos sean muy eficientes, ya que el proceso se realiza con un mínimo de episodios asistenciales y solamente en los pacientes adecuados. El coste del tratamiento varía sustancialmente en función de la complejidad de la intervención y el escenario quirúrgico donde se realiza.

Palabras clave:
Cáncer cutáneo
Dermatología quirúrgica
Proceso asistencial
Coste por proceso
Abstract
Background

Skin cancer is the most common form of malignancy in humans. It can be treated with various techniques and by different specialists. The procedure with the lowest failure rates is surgical excision.

Objectives

To calculate the cost per episode of care in the surgical treatment of non-melanoma skin cancer (NMSC) when performed by dermatologists.

Material and method

An episode of NMSC surgical care was defined as the series of healthcare services required for a dermatologist to treat skin cancer. The cost per episode was calculated using the economic data made available by the public health institution in which the analysis was performed.

Results

The cost per episode of care varied between 273.71 and 1,129.84 euro, depending on the surgical procedure performed and the related health services required.

Conclusions

Skin cancer is one of the cutaneous diseases with clinical manifestations that are easily recognized by dermatologists, who frequently do not even need histological confirmation to make the diagnosis and choose the therapeutic approach. Consequently, dermatological surgeons are highly efficient, since the episode of care is performed with a minimum of healthcare services and only in appropriately selected individuals. The cost of treatment varies substantially, depending on the complexity of the surgical procedures and the site where they are performed.

Key words:
Skin cancer
Surgical dermatology
Surgical care
Cost per episode
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Bibliografía
[1.]
D.L. Miller, M.A. Weinstock.
Nonmelanoma skin cancer in the United Stated: incidence.
J Am Acad Dermatol, 30 (2000), pp. 774-778
[2.]
M.R. Hussein.
Ultraviolet radiation and skin cancer: molecular mechanisms.
J Cutan Pathol, 32 (2005), pp. 191-205
[3.]
F. Bath-Hextall, J. Bong, W. Perkins, H. Williams.
Interventions for basal cell carcinoma of the skin: systematic review.
[4.]
T.S. Housman, P.M. Williford, S.R. Feldman, H.V. Teuschler, A.B. Fleischer Jr, N.D. Goldman, et al.
Nonmelanoma skin cancer: an episode of care management approach.
Dermatol Surg, 29 (2003), pp. 700-711
[5.]
M.F. Roizen, J.F. Fross, S.P. Fischer.
Preoperative evaluation.
Anesthesia, 5th ed., pp. 824-883
[6.]
K.A. Eagle, B.H. Brundage, B.R. Chaitman, G.A. Ewy, L.A. Fleisher, N.R. Hertzer, et al.
Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Commitee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery).
J Am Coll Cardiol, 27 (1996), pp. 910-948
[7.]
M.J. Larson, R.S. Taylor.
Monitoring vital signs during outpatient Mohs and post-Mohs reconstructive surgery performed under local anesthesia.
Dermatol Surg, 30 (2005), pp. 777-783
[8.]
T.S. Housman, S.R. Feldman, P.M. Williford, A.B. Fleischer, N.D. Goldman, J.M. Acostamadiedo, et al.
Skin cancer is among the most costly of all cancers to treat for the Medicare population.
J Am Acad Dermatol, 48 (2003), pp. 25-29
[9.]
American Cancer Society Cancer facts and figures 2000. Disponible en: http://www.cancer.org
[10.]
C.C. Boring, T.S. Squires, T. Tong, S. Montgomery.
Cancer statistics, 1994.
CA Cancer J Clin, 44 (1994), pp. 7-26
[11.]
J.G. Chen, A.B. Fleischer Jr, E.D. Smith, C. Kancler, N.D. Goldman, P.M. Williford, et al.
Cost of nonmelanoma skin cancer treatment in the United States.
Dermatol Surg, 27 (2001), pp. 1035-1038
[12.]
R.A. Skidmore, P.F. Flowers.
Nonmelanoma skin cancer.
Med Clin North Am, 82 (1998), pp. 1309-1323
[13.]
A.K. Joseph, T.L. Mark, C. Mueller.
The period prevalence and costs of treating nonmelanoma skin cancers in patients over 65 years of age covered by medicare.
Dermatol Surg, 27 (2001), pp. 955-959
[14.]
Humana, AADA study cost of treating cancer, common skin ailments. Dermatol World. 2001;11:6.
[15.]
T. Manternach, T.S. Housman, P.M. Williford, H. Teuschler, A.B. Fleischer Jr., S.R. Feldman, et al.
Surgical treatment of nonmelanoma skin cancer in the Medicare population.
Dermatol Surg, 29 (2003), pp. 1167-1169
[16.]
A.B. Fleischer Jr, S.R. Feldman, J.O. Barlow, B. Zheng, H.B. Hahn, T.Y. Chuang, et al.
The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: results from a multi-institutional retrospective study.
J Am Acad Dermatol, 44 (2001), pp. 224-230
[17.]
K. Johansen.
Comparison of information: a way to improve the quality of health care.
Qual Assur Health Care, 4 (1992), pp. 329-336
[18.]
L.H. Rosser Jr, B.H. Kleiner.
Using management information systems to enhance health care quality assurance.
J Manag Med, 9 (1995), pp. 27-36
[19.]
C. Bodart, S. Sapirie.
Defining essential information needs and indicators.
World Health Forum, 19 (1998), pp. 303-309
[20.]
J. García-Solano, A. López-Ávila, A. Acosta, S. Montalbán, C. Sánchez-Sánchez, A. Benito, et al.
Cánceres cutáneos de estirpe no melanocítica con márgenes quirúrgicos histológicos afectos. Estudio comparativo entre los servicios implicados en su extirpación quirúrgica.
Actas Dermosifiliogr, 95 (2004), pp. 358-361
[21.]
D. De Argila, I.M. Rodríguez-Nevado, A. Chaves.
Sobre la variabilidad de la práctica médica en los cáncer de piel.
Actas Dermosifiliogr, 96 (2005), pp. 66-67
[22.]
E.S. Smith, S.R. Feldman, A.B. Fleischer Jr, B. Leshin, A. McMichael.
Characteristics of office-based visits for skin cancer. Dermatologists have more experience than other physicians in managing malignant and premalignant skin conditions.
Dermatol Surg, 24 (1998), pp. 981-985
[23.]
S.R. Feldman, M.L. Coates.
Comparing the diagnostic accuracy of dermatologists and nondermatologists.
Arch Dermatol, 137 (2001), pp. 1645-1646
[24.]
M.I. Duque, J.R. Jordan, A.B. Fleischer Jr, P.M. Williford, S.R. Feldman, H. Teuschler, et al.
Frequency of seborrheic keratosis biopsies in the United States: a benchmark of skin lesion care quality and cost effectiveness.
Dermatol Surg, 29 (2003), pp. 796-801
Copyright © 2006. Sociedad Española de Salud Pública y Administración Sanitaria
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