Cost Effectiveness of the Rural Breast Cancer Survivor Intervention Package

描述(由申请人提供)：有效的医疗和健康相关干预措施的开发和验证一直是干预研究和干预研究人员的长期目标。然而，目前每个美国人每年在这方面的平均花费超过7000美元。这一数额继续增加，在国民生产总值中的消费比例也在不断提高。这一趋势必须改变。虽然有效性是干预研究的一个恒定目标，但成本效益一直是一个不太频繁但越来越重要的研究目标。成本效益和成本效益分析可能成为所有后期人类干预研究的基本和预期要素。拟议项目的总体目标是确定电话支持的农村乳腺癌幸存者干预(A)的成本效益 心理教育支持干预)与农村居民乳腺癌幸存者在癌症治疗第一个疗程后获得的通常护理进行比较。RBCS是专门为农村居民幸存者而调整的，此前在NIH资助的一项试验中显示，干预一揽子计划是有效的。为了实现总体目标和解决拟议项目的具体目标，研究小组经过精心挑选，以提供干预研究、癌症存活率、成本效益分析和卫生经济学方面的强大经验和专业知识，以解决拟议项目的各个方面。具体目标是：(1)确定农村社区卫生服务对生活质量的影响；(2)确定实施农村社区卫生服务的成本；(3)确定参与农村社区卫生服务对(A)卫生保健利用率、(B)护理费用和(C)参与者自付费用的影响；以及(4)确定与常规护理相比，农村社区卫生服务的增量成本效益。在拟议的分析中，有效性将通过与通常护理(对照)参与者相比，RBCs参与者的生活质量改善来衡量。将把收益与实施干预措施的成本以及参加央行可能产生的潜在额外成本进行比较。其中包括更好地遵守监测指南的成本，由医疗保健支付者和参与者自掏腰包支付。它还包括RBCS参与者可能因支持干预而被鼓励使用的额外服务的费用，例如咨询。成本效益分析将比较RBCs的增量成本和结果，以确定生活质量的增量收益是否值得分配资源来提供和参与这一干预。分析将从社会、乳腺癌幸存者和第三方付款人的角度进行。理想情况下，研究结果不仅可以更好地确定维持干预一揽子服务的成本以及对参与者的具体影响，而且还将提供重要的成本效益数据，以便更好地向消费者、支付者和政策提供信息。 公共卫生相关性：这将使我们能够检查农村乳腺癌幸存者对医疗保健使用、护理成本和自付费用的影响。

DESCRIPTION (provided by applicant): The development and validation of effective medical and health-related interventions have been longstanding targets of intervention research and intervention researchers. However, the average amount currently spent on every American exceeds $7,000 per year. This amount continues to increase and consume an ever-increasing proportion of the gross national product. The trend must be altered. While effectiveness is a constant target of intervention research, cost effectiveness has been a less frequent but increasingly important research target. Cost benefit and cost effectiveness analyses may become an essential and expected elements of all late-stage human intervention research. The overall goal of the proposed project is to determine the cost-effectiveness of the telephone-supported Rural Breast Cancer Survivors (RBCS) Intervention (a Psycho-educational support intervention) compared to the usual care available to rural dwelling breast cancer survivors after the first course of cancer treatment. The RBCS was adapted specifically for rural-dwelling survivors from of an intervention package that had previously been shown to be effective in an NIH funded trial. To achieve the overall goal and address the specific aims of the proposed project, the research team has been carefully selected to provide a formidable combination of experience and expertise in intervention research, cancer survivorship, cost-effectiveness analysis and health economics to address the various facets of the proposed project. The specific aims are to: (1) determine the effects of the RBCS on quality of life; (2) To determine the cost of implementing the RBCS; (3) determine the impact of participating in the RBCS on (a) health care utilization, (b) cost of care and (c) participant out-of-pocket costs, and; (4) determine the incremental cost effectiveness of the RBCS compared to usual care. In the proposed analyses, effectiveness will be measured by the improvement in quality of life for RBCS participants compared to usual care (control) participants. Benefits will be compared to the costs of delivering the intervention as well as to potential additional costs that may derive as a result of participating in the RBCS. These include the costs of better adherence to surveillance guidelines paid by health care payers and by participants out of pocket. It also includes costs for additional services RBCS participants may be encouraged to use as a result of the support intervention, for example counseling. The cost-effectiveness analysis will compare incremental costs and outcomes of the RBCS to determine whether the incremental gain in quality of life is worth the allocation of resources to deliver and participate in this intervention. Analyses will be done from the perspectives of society, breast cancer survivors and third party payers. Study results will ideally not only allow better determinations of the costs of maintaining the intervention package as a service and the specific effects on participants, but also will provide important cost-effectiveness data to better inform consumers, payers and policy. PUBLIC HEALTH RELEVANCE: The will allow us to examine the impact of the Rural Breast Cancer Survivors on health care use, costs of care, and out of pocket expenses.