Cost Effectiveness of the Rural Breast Cancer Survivor Intervention Package

描述（由申请人提供）：开发和验证有效的医疗和健康相关干预措施一直是干预研究和干预研究人员的长期目标。然而，目前平均每年花在每个美国人身上的钱超过7,000美元。这一数额继续增加，消耗的国民生产总值比例越来越大。这种趋势必须改变。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常见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（RBCS）干预（a）的成本效益 心理教育支持干预）与癌症治疗第一个疗程后农村乳腺癌幸存者可获得的常规护理相比。RBCS是专门为农村居住的幸存者改编的干预方案，以前已被证明是有效的，在美国国立卫生研究院资助的试验。为了实现总体目标和解决拟议项目的具体目标，研究团队经过精心挑选，提供了强大的经验和专业知识，在干预研究，癌症生存，成本效益分析和卫生经济学，以解决拟议项目的各个方面。具体目标是：（1）确定RBCS对生活质量的影响;（2）确定实施RBCS的成本;（3）确定参与RBCS对（a）卫生保健利用率、（B）护理成本和（c）参与者自付成本的影响;（4）确定与常规护理相比，RBCS的增量成本效益。在拟定的分析中，将通过与常规治疗（对照）受试者相比，RBCS受试者的生活质量改善来衡量有效性。将把效益与提供干预措施的费用以及参与风险控制系统可能产生的额外费用进行比较。其中包括更好地遵守监测指南的费用，这些费用由医疗保健支付者和参与者自掏腰包支付。它还包括额外服务的费用RBCS参与者可能会被鼓励使用作为支持干预的结果，例如咨询。成本效益分析将比较RBCS的增量成本和成果，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措施。将从社会、乳腺癌幸存者和第三方支付者的角度进行分析。理想的情况是，研究结果不仅能够更好地确定维持一揽子干预措施作为一种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，以便更好地告知消费者、付款人和政策。 公共卫生相关性：这将使我们能够研究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.