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Cost Effectiveness and Resource Allocation
Published in: Cost Effectiveness and Resource Allocation 1/2013

Open Access 01-12-2013 | Research

Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature

Authors: K Melissa Ke, Jane M Blazeby, Sean Strong, Fran E Carroll, Andy R Ness, William Hollingworth

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2013

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Abstract

Objective

To investigate the cost effectiveness of management of patients within the context of a multidisciplinary team (MDT) meeting in cancer and non-cancer teams in secondary care.

Design

Systematic review.

Data sources

EMBASE, MEDLINE, NHS EED, CINAHL, EconLit, Cochrane Library, and NHS HMIC.

Eligibility criteria for selecting studies

Randomised controlled trials (RCTs), cohort, case–control, before and after and cross-sectional study designs including an economic evaluation of management decisions made in any disease in secondary care within the context of an MDT meeting.

Data extraction

Two independent reviewers extracted data and assessed methodological quality using the Consensus on Health Economic Criteria (CHEC-list). MDTs were defined by evidence of two characteristics: decision making requiring a minimum of two disciplines; and regular meetings to discuss diagnosis, treatment and/or patient management, occurring at a physical location or by teleconferencing. Studies that reported on the costs of administering, preparing for, and attending MDT meetings and/or the subsequent direct medical costs of care, non-medical costs, or indirect costs, and any health outcomes that were relevant to the disease being investigated were included and classified as cancer or non-cancer MDTs.

Results

Fifteen studies (11 RCTs in non-cancer care, 2 cohort studies in cancer and non-cancer care, and 2 before and after studies in cancer and non cancer care) were identified, all with a high risk of bias. Twelve papers reported the frequency of meetings which varied from daily to three monthly and all reported the number of disciplines included (mean 5, range 2 to 9). The results from all studies showed mixed effects; a high degree of heterogeneity prevented a meta-analysis of findings; and none of the studies reported how the potential savings of MDT working may offset the costs of administering, preparing for, and attending MDT meetings.

Conclusions

Current evidence is insufficient to determine whether MDT working is cost-effective or not in secondary care. Further studies aimed at understanding the key aspects of MDT working that lead to cost-effective cancer and non-cancer care are required.
Appendix
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Metadata
Title
Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature
Authors
K Melissa Ke
Jane M Blazeby
Sean Strong
Fran E Carroll
Andy R Ness
William Hollingworth
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2013
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/1478-7547-11-7

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