A retrospective cost-effectiveness analysis of colorectal cancer screening in a public hospital. Savings from reduced hospitalization.
We compared the actual diagnosis and treatment costs for nine colon cancer and 19 polyp patients detected by occult blood screening with excess hospitalization costs incurred by a comparable group of traditionally detected patients. Program benefits were calculated from data on group differentials in surgical length of stay, readmissions in the year following surgery, and preventive polypectomies. A sensitivity analysis was performed to evaluate varying estimates of the percentage of polyps that may have become cancers, the urgency of presentation of clinically apparent cancer, and the inclusion or exclusion of the observed differences for hospitalization in the year after surgery. Two year program benefits varied from 59% to 185% of program costs. Adjusting estimates with DRG weightings for resource intensity produced considerably higher benefits. All estimates of program benefits are conservative because screened patients were compared with the 15-20% least severely ill, most favorably staged of all traditionally detected colon cancer patients admitted. Results indicate that occult blood screening programs may produce significant benefits derived from outpatient diagnosis, preventive polypectomies, coordination of care between medical and surgical services, and enhanced patient education.
D002641:Chicago; D003110:Colonic Neoplasms / Q000191:economics / Q000517:prevention & control* / Q000601:surgery; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D006746:Hospital Bed Capacity, 500 and over; D006766:Hospitals, County / Q000191:economics*; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics*; D009780:Occult Blood; D010359:Patient Readmission / Q000706:statistics & numerical data