title: The cost of implementing a 2-1-1 call center-based cancer control navigator program.
abstract: OBJECTIVE
  Determine the cost of implementing a call center-based cancer screening navigator program.
  
  
  METHODS
  Social service call centers in Houston and Weslaco, TX, assessed cancer risks and implemented cancer screening promotion and navigation. Micro costing was used to estimate the program costs. Staff logs and call records tracked personnel time and material costs, including a standard 30% overhead rate. Sensitivity analysis examined the effect of varying uncertain cost parameters. Scale effects were simulated for larger population coverage.
  
  
  RESULTS
  The total cost to recruit and navigate 732 persons, out of 2933 individuals who called the center was $215,847. The participant time cost was $19,503, and the personnel cost was $116,523. The cost per navigated participant was $295 (95% CI, $290.56-$298.07). The average cost per participant for recruitment and referral only, was $36 (95% CI, $34.9-$36.9). Average cost declines to $34 for recruitment and referral, and to $225 for recruitment, referral, and navigation when the number of participants increases to 15,000 individuals.
  
  
  CONCLUSIONS
  Expanding 2-1-1 referral services with opportunistic cancer screening promotion takes advantage of existing infrastructure but requires substantial additional staff time, participant time, and budget. Cost estimation is the first step in a full economic evaluation and informs program planners and decision-makers on the resource and budgetary requirements of this innovative strategy for increasing cancer screening in low income communities.
authors.affiliation: Center for Health Services Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. David.R.Lairson@uth.tmc.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Lairson
authors.forename: Jinhai
authors.initials: J
authors.lastname: Huo
authors.forename: Katharine A Ball
authors.initials: KA
authors.lastname: Ricks
authors.forename: Lara
authors.initials: L
authors.lastname: Savas
authors.forename: María E
authors.initials: ME
authors.lastname: Fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D017048:Health Care Costs; D006284:Health Plan Implementation / Q000191:economics; D015277:Hotlines / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000458:organization & administration; D008875:Middle Aged; D017059:Models, Econometric; D009369:Neoplasms / Q000517:prevention & control*; D062526:Patient Navigation / Q000191:economics* / Q000458:organization & administration; D015397:Program Evaluation / Q000191:economics; D012017:Referral and Consultation / Q000191:economics / Q000458:organization & administration; D018570:Risk Assessment; D013781:Texas