cost-analysis and patient experience of a one-stop bariatric clinic david bunting ian finlay
TRANSCRIPT
![Page 1: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/1.jpg)
Cost-analysis and patient experience of a one-stop bariatric
clinic David Bunting
Ian Finlay
![Page 2: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/2.jpg)
Background
• Royal Cornwall Hospital
• Single bariatric centre in Cornwall
• Resident population 535,300*
• Sparsely populated
*Office of National Statistics mid year estimate 2010
![Page 3: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/3.jpg)
Office of National Statistics
![Page 4: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/4.jpg)
![Page 5: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/5.jpg)
Background – NICE Guidance
![Page 6: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/6.jpg)
NICE Guidance
• ‘all appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months’
• Consultations prior to considering surgery– Endocrinologist– Dietician– Exercise therapist
![Page 7: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/7.jpg)
Background
• Care should be within a multidisciplinary team
• One-stop clinic developed
• Consultations required before decision on surgery– Dietician– Anaesthetist – Surgeon
![Page 8: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/8.jpg)
Background
• Free on-site parking
• Three separate consulting rooms
• Afternoon appointments
• Prior to decision regarding suitability for surgery
![Page 9: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/9.jpg)
Study aims
• Patient views/satisfaction
• Strengths and weaknesses
• Identify savings compared to three-stop clinic – travelling time – travelling distance– cost of travel
![Page 10: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/10.jpg)
Methods
• 1 year period
• Patient survey– 10-point visual analogue scale– tick-boxes – free-text boxes
• Travelling distances and times recorded
• Travel cost estimated
• Savings calculated
![Page 11: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/11.jpg)
Results
• 29/46 patients responded (63%)
![Page 12: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/12.jpg)
Duration of appointment
![Page 13: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/13.jpg)
Usefulness of appointment
![Page 14: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/14.jpg)
Efficiency of clinic
![Page 15: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/15.jpg)
Ease of getting to clinic
![Page 16: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/16.jpg)
Journey distance one-way
![Page 17: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/17.jpg)
Journey times – one way
![Page 18: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/18.jpg)
Results
• Distance travelled– Average 23.3 miles one-way
• Travel time– Average 1hr 36 minutes one-way
• Travel cost– Average £9.31
![Page 19: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/19.jpg)
Results
• Travel distance saved– 93 miles per patient (up to 228 miles)
• Travel time saved– 3 hours 13 minutes per patient (up to 10
hours)
• Travel cost saving– £37.20 (up to £91.20)
![Page 20: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/20.jpg)
Waited longer than expected
![Page 21: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/21.jpg)
Waited longer than necessary
![Page 22: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/22.jpg)
Prefer one-stop clinic
![Page 23: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/23.jpg)
Patient comments
• Not enough information on post-operative diet
• Decision regarding suitability for surgery not made on the day
• Long distance to clinic
• Travelling time
![Page 24: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/24.jpg)
Patient comments
• On-site free parking
• Friendliness of staff
• Not made to feel guilty
• Not rushed
• Put at ease
• Good information/advice given
![Page 25: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/25.jpg)
Limitations
• Response rate– sampling bias
• Survey delivered by hospital– positive satisfaction bias
![Page 26: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/26.jpg)
Conclusions
• One-stop clinic– Feasible– Acceptable to patients– Considerable reductions in travelling distance
and times
• Inform patients prior to clinic– Process can take up to 3 hours– Decision regarding surgery not made instantly
![Page 27: Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay](https://reader036.vdocuments.mx/reader036/viewer/2022062417/551a08235503464c588b4e5b/html5/thumbnails/27.jpg)
Acknowledgements
• Bariatric team– Surgeons– Dieticians– Anaesthetists– Bariatric secretary– Bariatric nurse specialist
• Patients