Costs and effects of implementation of a short admission programme following breast cancer surgery in the Netherlands

This dissertation investigates if short-stay breast cancer surgery (day or 24 hour case) is safe and efficient, studying the experiences of patients. A short stay programme was implemented in four Dutch hospitals. The proportion of patients who had short-stay treatment significantly increased after implementation from 45% to 82%, while the number of complications, rehospitalisation, reoperations or number of visits to the emergency department did not increase. The programme is less expensive than the usual care, even if the costs of implementation are taken into account. Research into the experiences of patients showed that especially the information provision needed to be improved. On the basis of these research results large-scale implementation of the programme is recommended.