title: How accessible is the breast screening assessment centre for Lanarkshire women?
abstract: The National Breast Screening Programme in Lanarkshire utilises a mobile screening unit to facilitate access for the catchment population. However, women who require further investigation (8% of the total) have to travel to a regional Assessment Centre in Glasgow. This Centre in Glasgow may be difficult to access by some Lanarkshire residents, especially those who need to use public transport. The objective of this study was to assess the accessibility of the Assessment Centre for a Breast Screening Programme in terms of travelling and social cost. This study was based on systematic samples of patients (n = 109) attending the Assessment Centre in a 12 month period, using a self-completion questionnaire. The sample formed 11.9% of attenders. The cost of attending the Centre is high because of the long distance (average return journey 21.5 miles, range 14-46 miles), long travel time (mean 1.73 hours, range 0.5 to 5.5 hours), multiple journeys (2-6 journeys) and high actual cost (mean 6.08 pounds, range 1 pound to 14.40 pounds). Regional Assessment Centres are necessary to maintain the appropriate level of expertise and quality of the Programme, but Assessment Centres should be sensitive to, and monitor the difficulties faced by women in attending. More generally, costs to patients to obtain a service are not usually taken into account by the service providers. Purchasers of health services should take a societal standpoint when assessing the cost effectiveness of services so that it is not at the expense of individual patients.
authors.affiliation: Lanarkshire Health Board, University of Glasgow.
authors.forename: H S
authors.initials: HS
authors.lastname: Kohli
authors.forename: P Y
authors.initials: PY
authors.lastname: Teo
authors.forename: F M
authors.initials: FM
authors.lastname: Howie
authors.forename: H M
authors.initials: HM
authors.lastname: Dobson
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D003954:Diagnostic Services / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D012494:Sampling Studies; D012606:Scotland; D014186:Transportation / Q000191:economics