Collecting Direct Non-Health Care and Time Cost Data: Application to Screening and Diagnosis of Cervical Cancer

Cantor, Scott B.; Levy, Lawrence B.; Cardenas‐Turanzas, Marylou; Basen-Engquist, Karen; Le, Tao; Follen, Michele

doi:10.1177/027298906288679

Cited by 23 publications

(18 citation statements)

References 11 publications

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“…Such a strategy has been employed in other studies as well. 41 Finally, the study is limited by the small sample of case families obtained from the birth defects registry. Obtaining cases from a different geographical region with a larger population could produce samples to obtain estimates with greater precision.…”

Section: Discussionmentioning

confidence: 99%

Labor Market Productivity Costs for Caregivers of Children with Spina Bifida: A Population-Based Analysis

et al. 2009

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Background. Caregiver productivity costs are an important component of the overall cost of care for individuals with birth defects and developmental disabilities, yet few studies provide estimates for use in economic evaluations. Objective. This study estimates labor market productivity costs for caregivers of children and adolescents with spina bifida. Methods. Case families were recruited from a state birth defects registry in Arkansas. Primary caregivers of children with spina bifida (N = 98 ) reported their employment status in the past year and demographic characteristics. Controls were abstracted from the Current Population Survey covering the state of Arkansas for the same time period (N = 416 ). Estimates from regression analyses of labor market outcomes were used to calculate differences in hours worked per week and lifetime costs. Results. Caregivers of children with spina bifida worked an annual average of 7.5 to 11.3 hours less per week depending on the disability severity. Differences in work hours by caregivers of children with spina bifida translated into lifetime costs of $133,755 in 2002 dollars using a 3% discount rate and an age- and sex-adjusted earnings profile. Including caregivers' labor market productivity costs in prevention effectiveness estimates raises the net cost savings per averted case of spina bifida by 48% over the medical care costs alone. Conclusions. Information on labor market productivity costs for caregivers can be used to better inform economic evaluations of prevention and treatment strategies for spina bifida. Cost-effectiveness calculations that omit caregiver productivity costs substantially overstate the net costs of the intervention and underestimate societal value.

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Section: Discussionmentioning

confidence: 99%

Labor Market Productivity Costs for Caregivers of Children with Spina Bifida: A Population-Based Analysis

et al. 2009

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“…Most previous studies measured patient time using clinic schedules or retrospective surveys. 13,14,32,35,36,42,45-48 Few used prospective patient time diaries, 6,7 which may be a better way to obtain reliable data on time allocation. 49 …”

Section: Discussionmentioning

confidence: 99%

Patient Time Requirements for Anticoagulation Therapy with Warfarin

et al. 2009

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Background Most patients receiving warfarin are man- aged in outpatient office settings or anticoagulation clinics that require frequent visits for monitoring. Objective To measure the amount and value of time required of patients for chronic anticoagulation therapy with warfarin. Design/Participants Prospective observation of a cohort of adult patients treated at a university-based anticoagulation program. Measurements Participants completed a questionnaire and a prospective diary of the time required for 1 visit to the anticoagulation clinic, including travel, waiting, and the clinic visit. The authors reviewed subjects’ medical records to obtain additional information, including the frequency of visits to the anti- coagulation clinic. They used the human capital method to estimate the value of time. Results Eighty-five subjects completed the study. The mean (median) total time per visit was 147 minutes (123). Subjects averaged 15 visits per year (14) and spent 39.0 hours (29.3) per year on their visits. Other anticoagulation-related activities, such as communication with providers, pharmacy trips, and extra time preparing food, added an average of 52.7 hours (19.0) per year. The mean annual value of patient time spent traveling, waiting, and attending anticoagulation visits was $707 (median $591). The mean annual value when also including other anticoagulation-related activities was $1799 (median $1132). Conclusions The time required of patients for anticoagulation visits was considerable, averaging approximately 2.5 hours per visit and almost 40 hours per year. Methods for reducing patient time requirements, such as home-based testing, could reduce costs for patients, employers, and companions.

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“…Costs comprised direct medical costs associated with screening, diagnosis, and treatment for precancer and invasive cancer (e.g., tests, procedures, hospitalizations), based on national-average Medicare reimbursement rates and cost estimates from a previous analysis (Appendix Table 2) (21, 26). Direct non-medical costs, such as patient time and transportation, were also included for all strategies (27, 28). …”

Section: Methodsmentioning

confidence: 99%

Inefficiencies and High-Value Improvements in U.S. Cervical Cancer Screening Practice

Kim¹,

Campos²,

Sy³

et al. 2015

Ann Intern Med

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Background Studies suggest that cervical cancer screening practice in the United States is inefficient. The cost and health implications of non-compliance in the screening process compared to recommended guidelines are uncertain. Objective To estimate the benefits, costs, and cost-effectiveness of current cervical cancer screening practice and assess the value of screening improvements. Design Model-based cost-effectiveness analysis. Data Sources New Mexico HPV Pap Registry; medical literature. Target Population Cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Societal. Interventions Current cervical cancer screening practice; improved compliance to guidelines-based screening interval, triage testing, diagnostic referrals, and precancer treatment referrals. Outcome Measures Reductions in lifetime cervical cancer risk, quality-adjusted life-years (QALYs), lifetime costs, incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs Results of Base-Case Analysis Current screening practice was associated with lower health benefit and was not cost-effective relative to guidelines-based strategies. Improvements in the screening process were associated with higher QALYs and small changes in costs. Perfect c4mpliance to a 3-yearly screening interval and to colposcopy/biopsy referrals were associated with the highest INMBs ($759 and $741, respectively, at a willingness-to-pay threshold of $100,000 per QALY gained); together, the INMB increased to $1,645. Results of Sensitivity Analysis Current screening practice was inefficient in 100% of simulations. The rank ordering of screening improvements according to INMBs was stable over a range of screening inputs and willingness-to-pay thresholds. Limitations The impact of HPV vaccination was not considered. Conclusions The added health benefit of improving compliance to guidelines, especially the 3-yearly interval for cytology screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice. Funding Source U.S. National Cancer Institute.

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Collecting Direct Non-Health Care and Time Cost Data: Application to Screening and Diagnosis of Cervical Cancer

Cited by 23 publications

References 11 publications

Labor Market Productivity Costs for Caregivers of Children with Spina Bifida: A Population-Based Analysis

Labor Market Productivity Costs for Caregivers of Children with Spina Bifida: A Population-Based Analysis

Patient Time Requirements for Anticoagulation Therapy with Warfarin

Inefficiencies and High-Value Improvements in U.S. Cervical Cancer Screening Practice

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