title: Costs and cost-effectiveness of a clinical intervention to increase mammography utilization in an inner city public health hospital.
abstract: BACKGROUND
  Studies have demonstrated the cost-effectiveness of screening women for breast cancer; however, the cost-effectiveness of strategies to motivate women to receive breast cancer screening has been less well studied.
  
  
  METHODS
  A total of 196 women, aged 50 to 74, who were enrolled in a public health hospital clinic, were noncompliant with mammography screening, and had at least one routine clinic appointment during the study period (15 months) were entered into a randomized, controlled trial of a motivational intervention to increase mammography rates. Costs were captured via a modified Delphi technique, accounting records, sampling of staff time logs, and an estimation of miscellaneous and overhead costs. Summary costs were calculated using Excel spread sheets.
  
  
  RESULTS
  Overall, 49% of women who received the intervention had a mammogram within 8 weeks of an index visit compared with 22% of control women. Calculation of the cost-effectiveness of the project showed an additional cost of $151 (1996 U.S.$) for each woman receiving the intervention and $559 for each additional woman motivated to receive a mammogram.
  
  
  CONCLUSIONS
  Cost tracking and cost-effectiveness analysis can be done when intervening in a clinical setting, thereby allowing clinics to make informed decisions about implementing programs to increase motivation of their patients to receive screening.
authors.affiliation: Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, MP-702, Seattle, Washington 98109-1024, USA. bthompso@fhcrc.org
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.forename: L Anne
authors.initials: LA
authors.lastname: Thompson
authors.forename: M Robyn
authors.initials: MR
authors.lastname: Andersen
authors.forename: Shelly
authors.initials: S
authors.lastname: Hager
authors.forename: Victoria
authors.initials: V
authors.lastname: Taylor
authors.forename: Nicole
authors.initials: N
authors.lastname: Urban
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000523:psychology; D003365:Costs and Cost Analysis; D005260:Female; D006779:Hospitals, Public / Q000191:economics; D006786:Hospitals, Urban / Q000191:economics; D006801:Humans; D008327:Mammography / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D018803:Models, Economic; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D015397:Program Evaluation