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    Postbreast cancer surgery outpatient rehabilitation program: Analysis of clinical profile, impact, and direct medical costs

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    Context: Approximately 600,000 new cases of cancer are estimated to occur in Brazil over the 2-year period of 2018–2019, and the world economic impact of cancer was 895billiondollarsin2008.Aims:Toperformananalysiscontemplatingtheclinicalprofile,impact,anddirectmedicalcostsofanoutpatientrehabilitationprogramforpatientswhohaveundergonebreastcancersurgery.SettingsandDesign:ApartialeconomicanalysiswasperformedfromtheperspectiveofaBrazilianpublichospital.SubjectsandMethods:Anobservationalstudywasconductedusingdatafromaretrospectivecohortofpatientswhohadundergonebreastcancersurgery.ThesepatientshadtheirfirstrehabilitationappointmentbetweenAugust2015andJuly2016.StatisticalAnalysisUsed:Pearson′sChi−squaretestorFisher′sexacttest,Student′st−test,Fisher′sF−testanalysisofvariance,orthenonparametricKruskal–Wallistest.Posthoctestswereconductedtocheckfordifferencesbetweenthepairsofcategories.ThenonparametricKolmogorov–Smirnovtestevaluatedthedatanormality.Allhypothesistestingusedasignificancelevelof5895 billion dollars in 2008. Aims: To perform an analysis contemplating the clinical profile, impact, and direct medical costs of an outpatient rehabilitation program for patients who have undergone breast cancer surgery. Settings and Design: A partial economic analysis was performed from the perspective of a Brazilian public hospital. Subjects and Methods: An observational study was conducted using data from a retrospective cohort of patients who had undergone breast cancer surgery. These patients had their first rehabilitation appointment between August 2015 and July 2016. Statistical Analysis Used: Pearson's Chi-square test or Fisher's exact test, Student's t-test, Fisher's F-test analysis of variance, or the nonparametric Kruskal–Wallis test. Post hoc tests were conducted to check for differences between the pairs of categories. The nonparametric Kolmogorov–Smirnov test evaluated the data normality. All hypothesis testing used a significance level of 5%. Results: A total of 132 patients underwent the referred rehabilitation program. The goal of total rehabilitation was achieved in approximately 70% of cases. There was improvement in patients' quality of life in most Short-Form Health Survey-36 dimensions. The program's direct cost had an overall median per patient of R 7235.32. Conclusions: The study found good results in the indicators of clinical outcome and quality of life. The costs were reported from a partial evaluation point of view and may contribute to future full evaluations
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