Cost-Effectiveness of Patient Mailings to Promote Colorectal Cancer Screening
Cost-Effectiveness of Patient Mailings to Promote Colorectal Cancer Screening
复制标题
DOI：
10.1097/mlr.0b013e3181dbd8eb
复制
发表时间：
2010-06-01
期刊：
影响因子：
3
通讯作者：
Ayanian, John Z.
中科院分区：
文献类型：
--
作者：
Sequist, Thomas D.;Franz, Calvin;Ayanian, John Z.
背景：促进结直肠癌筛查的项目很常见，但关于这种努力的成本-效果的信息有限。目的：评估患者邮寄以提高结直肠癌筛查率的成本-效果。研究设计：随机对照试验的增量成本-效果分析。这项干预措施涉及11个健康中心的21,860名年龄在50岁至80岁之间的患者，这些患者早该进行结直肠癌筛查。在基线和6个月的随访中，患者随机收到一封邮件，其中包括一封定制的信件、教育手册和粪便潜血检测试剂盒。测量：我们计算了这些邮件通过粪便潜血测试、弹性乙状结肠镜或结肠镜检查促进结直肠癌筛查的增量成本-效果，使用劳动力和用品的内部成本估计。结果：干预组患者的结直肠癌筛查率高于对照组患者(44%vs.38%，P<；0.001)。干预的总成本类似于每名患者5.48美元，导致每多筛查一名患者的成本-效果比为94美元。这一估计从69美元到156美元，基于对干预组件的成本、干预效果的大小、年龄范围和目标患者人群大小的假设。结论：定制患者邮件是提高结直肠癌筛查率的一种经济有效的方法。
Background: Programs to promote colorectal cancer screening are common, yet information regarding the cost-effectiveness of such efforts is limited.Objective: To assess the cost-effectiveness of patient mailings to increase rates of colorectal cancer screening.Research Design: Incremental cost-effectiveness analysis of a randomized, controlled trial. The intervention involved 21,860 patients aged 50 to 80 years across 11 health centers overdue for colorectal cancer screening. Patients were randomized to receive a mailing that included a tailored letter, educational brochure, and fecal occult blood test kit at baseline and 6 months follow-up.Measures: We calculated the incremental cost-effectiveness of these mailings to promote colorectal cancer screening by fecal occult blood testing, flexible sigmoidoscopy, or colonoscopy using internal cost estimates of labor and supplies.Results: Colorectal cancer screening rates were higher for patients in the intervention compared with control patients (44% vs. 38%, P < 0.001). The total cost of the intervention was similar to$5.48 per patient, resulting in a cost-effectiveness ratio of $94 per additional patient screened. This estimate ranged from $69 to $156, based on assumptions of the cost of the intervention components, magnitude of intervention effect, age range, and size of the targeted patient population.Conclusion: Tailored patient mailings are a cost-effective approach to improve rates of colorectal cancer screening.