Cost-effectiveness comparison of five interventions to increase mammography screening

Journal Name: 
Prev Med
Authors: 
Saywell,R.M.
Champion,V.L.
Skinner,C.S.
McQuillen,D.
Martin,D.
Maraj,M.
Abstract: 
BACKGROUND: Mammography is the primary method used for breast cancer screening. However, compliance with recommended screening practices is still below acceptable levels. This study examined the cost- effectiveness of five combinations of physician recommendation and telephone or in-person individualized counseling strategies for increasing compliance with mammography. METHODS: There were 808 participants who were randomly assigned to one of six groups. A logistic regression model with compliance as the dependent variable and group as the independent variable was used to test for significant differences and a ratio of cost to improvement in mammogram compliance evaluated the cost-effectiveness. RESULTS: Three of the interventions (in-person, telephone plus letter, and in-person plus letter) had significantly better compliance rates compared with the control, physician letter, or telephone alone. However, when considering costs, only one emerged as the superior strategy. The cost-effectiveness ratios for the five interventions show that telephone-plus-letter is the most cost-effective strategy, achieving a 35.6% mammography compliance at a marginal cost of $0.78 per 1% increase in women screened. CONCLUSIONS: A tailored phone prompt and physician reminder is an effective and economical intervention to increase mammography. Future research should confirm this finding and address its applicability to practice.
11
1999
Volume: 
29
Pages: 
374-82
Keywords: 
1340, Aged, better, Breast, Comparative Study, Comparison, Correspondence, cost, cost effectiveness, Cost-Benefit Analysis, Counseling, Counseling: economics: methods, differences, Female, Health Maintenance Organizations, Human, intervention, Logistic Models, Mammography, Mammography: utilization, Methods, Middle Age, Odds Ratio, Patient Compliance, regression, Reminder Systems: economics, Research, ResNet, Socioeconomic Factors, Support,U.S.Gov't,P.H.S., Telephone, United States, women