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Two indicators of hospital resource efficiency in cancer care.

Acute inpatient hospital stays represent a major portion of cancer care costs. All complex surgery and a significant portion of palliative care are delivered in the inpatient setting. Although a vast proportion of those services can be appropriate, ongoing cost pressures threatening the sustainability of the cancer care system warrant an examination of cases in which expensive inpatient care might not be the most cost-effective option. Here, we present two indicators that might help point to such cases: the percentage of day-surgery mastectomies for breast cancer and the use of the intensive care unit (icu) for cancer patients in the last 14 days of life. 
 
Although relatively invasive in nature, mastectomies can be safely performed as day surgery1. Day surgeries can be preferable to inpatient surgeries (in which a patient is admitted to a hospital bed after the operation to recover) when they consume fewer hospital resources, without at the same time compromising patient outcomes. 
 
Hospital icus are among the most resource-intensive patient care areas. Excessive use of critical care near end of life might indicate inappropriate utilization of resource-intensive acute care in situations in which palliative and supportive care in a non-acute setting might be more appropriate for the patient’s quality of life and constitute a better use of system resources2.