Imperial College London
Alternate

Richard M Kwasnicki PhD MRCS

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 5140richard.kwasnicki07

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kwasnicki:2024:10.1016/j.bjps.2023.11.025,
author = {Kwasnicki, RM and Irukulla, M and Che, Bakri NA and Whiteman, E and Gardiner, M and Dunne, J and Henry, FP and Gokani, V and Hunter, JE and Williams, G and Wood, SH},
doi = {10.1016/j.bjps.2023.11.025},
journal = {J Plast Reconstr Aesthet Surg},
pages = {466--472},
title = {Identifying variation in the cost of abdominally based breast reconstruction in the UK.},
url = {http://dx.doi.org/10.1016/j.bjps.2023.11.025},
volume = {88},
year = {2024}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIMS: To understand variation in the cost of autologous breast reconstruction in the UK, including identifying key areas of cost variability, differences between and within units and the impact of enhanced recovery protocols (ERAS). METHODS: A micro-costing study was designed based on the responses to a national survey of clinical preferences completed by the majority of plastic surgeons and anaesthetists involved in the UK. Detailed costs were estimated from macro elements such as ward and theatre running costs, down to that of surgical meshes, anaesthetic drugs and flap monitoring devices. RESULTS: The largest variation in cost arose from postoperative location and length of stay, preoperative imaging and flap monitoring strategies. Plastic surgeon costs varied from £1282 to £3141, whereas anaesthetic costs were between £32 and £151 (not including salary). Estimated cost variation within units was up to £893 per case. Units with ERAS had significantly lower total costs than those without (p<0.05). CONCLUSION: This study reveals significant cost variation in breast reconstruction in the UK based on clinician preferences. Many areas of practice driving this variation lack strong evidence of any clinical advantage. The total cost of a deep inferior epigastric perforator in the majority, if not all units, likely surpasses the national tariff for reimbursement, particularly when considering additional resource demand for immediate and bilateral breast reconstruction, as well as future symmetrisation procedures. Whilst units should look to streamline costs through ERAS, there should also be a realistic tariff that promotes excellent care.
AU  - Kwasnicki,RM
AU  - Irukulla,M
AU  - Che,Bakri NA
AU  - Whiteman,E
AU  - Gardiner,M
AU  - Dunne,J
AU  - Henry,FP
AU  - Gokani,V
AU  - Hunter,JE
AU  - Williams,G
AU  - Wood,SH
DO  - 10.1016/j.bjps.2023.11.025
EP  - 472
PY  - 2024///
SP  - 466
TI  - Identifying variation in the cost of abdominally based breast reconstruction in the UK.
T2  - J Plast Reconstr Aesthet Surg
UR  - http://dx.doi.org/10.1016/j.bjps.2023.11.025
UR  - https://www.ncbi.nlm.nih.gov/pubmed/38096767
VL  - 88
ER  -
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