Rapid Fire Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Delivering value in cancer care: costing analysis of a nurse-led geriatric oncology model of care (146357)

Alexandra Powell 1 , Nicole Knox 2 , Katie Knight 3 , Kim Edmunds 4 5 , Gemma McErlean 6 7 , Meera Agar 7 , Louise Hickman 8 , Shalini Vinod 2 9 10
  1. Radiation Oncology, Icon Cancer Therapy, Concord, NSW, Australia
  2. School of Nursing, University of Wollongong, Wollongong, NSW
  3. Macarthur Cancer Therapy, Campbelltown Hospital, Sydney, NSW
  4. Centre for the Business and Economics of Health , University of Queensland, Brisbane, QLD
  5. Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth, WA
  6. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW
  7. University of Technology , Sydney, NSW
  8. University of Sydney, Sydney, NSW
  9. Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW
  10. Faculty of Science, Medicine & Health , University of New South Wales, Sydney, NSW

Aim
Geriatric oncology interventions reduce treatment-related toxicity, healthcare utilisation and improve quality of life in older adults with cancer. Despite these benefits, implementation remains limited in resource-constrained health systems. We evaluated the costs, cost offsets and value for money of implementing a Nurse-Led Geriatric Oncology Model of Care (NL-GOMOC) for older adults with lung cancer.

Methods
A cost analysis was undertaken during a NL-GOMOC at an Australian metropolitan tertiary cancer centre from June 2023-May 2024. Intervention costs were estimated from Clinical Nurse Specialist (CNS) activity diaries capturing geriatric assessment, multidisciplinary review and follow-up. Costs associated with allied health referrals were included. Health service utilisation was compared with a historical cohort receiving usual care from January-December 2019. Emergency department presentations, hospital admissions and length of stay were extracted from local health service datasets. Costs were based on the local health service and National Weighted Activity Unit data.

Results
There were 100 patients in the NL-GOMOC and 92 patients in the historical usual care cohort. Implementation of the NL-GOMOC required 0.5 FTE CNS funding
($74 292 annually). Allied health utilisation increased compared with usual care ($37,940 vs $14,493), consistent with identification of supportive care needs. Despite increased supportive care investment, NL-GOMOC patients experienced fewer ED presentations (58 vs 97), shorter mean hospital admissions (6 vs 9 days), and lower total inpatient stay estimated costs ($1 988 692 vs $4 536 250). ED presentation costs were also reduced ($63 278 vs $105 827). Acute care savings exceeded implementation costs by $2.4 million dollars.

Conclusions
A Nurse-Led Geriatric Oncology Model of Care represents a high-value workforce investment, with upfront costs offset by improved access to supportive care, reduced acute healthcare utilisation and lower health-system costs.  These findings support broader implementation of nurse-led geriatric oncology services, to improve health outcomes and increase health-system efficiency for older adults with cancer.