Abstract
Melanoma-in-situ (MIS) is treated with surgical resection by many specialties. Dermatologists perform these procedures in outpatient settings while others often employ operating rooms and general anesthesia. We hypothesized that MIS managed by dermatology was less costly than that managed by other specialties. All cases of MIS treated at our institution over a 3-year period were evaluated retrospectively for demographic and clinical characteristics and categorized by treating specialty. Estimated cost information was determined using records of charges billed. The mean total cost for MIS treated with wide local excision (WLE) by dermatologists was $1089 (CI = $941–1237) versus all other specialties at $5172 (CI = $2419–7925) (p < 0.001). MIS treated with Mohs micrographic surgery and repaired by dermatology (mean = $2325, CI = $2241–2409) was also less expensive than MIS treated by other specialties with WLE (p < 0.001). The results suggest MIS is significantly less costly to patients and the health care system when treatment is performed by dermatologists compared to other surgical specialties. This is likely due to dermatologists performing the procedures in less expensive outpatient settings.
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Acknowledgements
We gratefully acknowledge the critical contributions of Cindy Kao, Robert McMullen, and James Buckley to the retrieval and interpretation of cost data for this study.
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All authors contributed to the study conception and design. The majority of procedures analyzed were performed by DS and RIN. Data collection, chart review and cost estimates were performed by KB, KL, AH and MOB. Data analysis and table construction were performed by KS. The first draft of the manuscript was written by KB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Ethical approval was waived by the UT Southwestern IRB in view of the retrospective nature of the study and all the procedures being performed were part of routine care.
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Burningham, K.M., Le, K., He, A. et al. Cost effectiveness of melanoma in situ resection and repair by dermatology compared to non-dermatology specialties at a single institution. Arch Dermatol Res 315, 661–663 (2023). https://doi.org/10.1007/s00403-022-02405-4
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DOI: https://doi.org/10.1007/s00403-022-02405-4