Costs and cost-effectiveness of a clinical intervention to increase mammography utilization in an inner city public health hospital.
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.
Thompson
Beti
B
Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, MP-702, Seattle, Washington 98109-1024, USA. bthompso@fhcrc.org
Thompson
L Anne
LA
Andersen
M Robyn
MR
Hager
Shelly
S
Taylor
Victoria
V
Urban
Nicole
N
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