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Cost-analysis and patient experience of a one-stop bariatric clinic

Cost-analysis and patient experience of a one-stop bariatric clinic. David Bunting Ian Finlay. Background. Royal Cornwall Hospital Single bariatric centre in Cornwall Resident population 535,300* Sparsely populated. *Office of National Statistics mid year estimate 2010.

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Cost-analysis and patient experience of a one-stop bariatric clinic

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  1. Cost-analysis and patient experience of a one-stop bariatric clinic David Bunting Ian Finlay

  2. Background • Royal Cornwall Hospital • Single bariatric centre in Cornwall • Resident population 535,300* • Sparsely populated *Office of National Statistics mid year estimate 2010

  3. Office of National Statistics

  4. Background – NICE Guidance

  5. 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

  6. Background • Care should be within a multidisciplinary team • One-stop clinic developed • Consultations required before decision on surgery • Dietician • Anaesthetist • Surgeon

  7. Background • Free on-site parking • Three separate consulting rooms • Afternoon appointments • Prior to decision regarding suitability for surgery

  8. Study aims • Patient views/satisfaction • Strengths and weaknesses • Identify savings compared to three-stop clinic • travelling time • travelling distance • cost of travel

  9. 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

  10. Results • 29/46 patients responded (63%)

  11. Duration of appointment

  12. Usefulness of appointment

  13. Efficiency of clinic

  14. Ease of getting to clinic

  15. Journey distance one-way

  16. Journey times – one way

  17. Results • Distance travelled • Average 23.3 miles one-way • Travel time • Average 1hr 36 minutes one-way • Travel cost • Average £9.31

  18. 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)

  19. Waited longer than expected

  20. Waited longer than necessary

  21. Prefer one-stop clinic

  22. 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

  23. Patient comments • On-site free parking • Friendliness of staff • Not made to feel guilty • Not rushed • Put at ease • Good information/advice given

  24. Limitations • Response rate • sampling bias • Survey delivered by hospital • positive satisfaction bias

  25. 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

  26. Acknowledgements • Bariatric team • Surgeons • Dieticians • Anaesthetists • Bariatric secretary • Bariatric nurse specialist • Patients

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