Cost-effectiveness comparison of five interventions to increase mammography screening

Robert M. Saywell, Victoria L. Champion, Celette Sugg Skinner, Diane McQuillen, Daniel Martin, Maltie Maraj

Research output: Contribution to journalArticle

71 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)374-382
Number of pages9
JournalPreventive Medicine
Volume29
Issue number5
DOIs
StatePublished - Nov 1999

Fingerprint

Mammography
Telephone
Cost-Benefit Analysis
Compliance
Costs and Cost Analysis
Physicians
Logistic Models
Early Detection of Cancer
Counseling
Breast Neoplasms

Keywords

  • Compliance rates
  • Cost-effectiveness
  • Mammography screening

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Cost-effectiveness comparison of five interventions to increase mammography screening. / Saywell, Robert M.; Champion, Victoria L.; Skinner, Celette Sugg; McQuillen, Diane; Martin, Daniel; Maraj, Maltie.

In: Preventive Medicine, Vol. 29, No. 5, 11.1999, p. 374-382.

Research output: Contribution to journalArticle

Saywell, Robert M. ; Champion, Victoria L. ; Skinner, Celette Sugg ; McQuillen, Diane ; Martin, Daniel ; Maraj, Maltie. / Cost-effectiveness comparison of five interventions to increase mammography screening. In: Preventive Medicine. 1999 ; Vol. 29, No. 5. pp. 374-382.
@article{c2227d02db7845d78203177553edc338,
title = "Cost-effectiveness comparison of five interventions to increase mammography screening",
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.",
keywords = "Compliance rates, Cost-effectiveness, Mammography screening",
author = "Saywell, {Robert M.} and Champion, {Victoria L.} and Skinner, {Celette Sugg} and Diane McQuillen and Daniel Martin and Maltie Maraj",
year = "1999",
month = "11",
doi = "10.1006/pmed.1999.0568",
language = "English (US)",
volume = "29",
pages = "374--382",
journal = "Preventive Medicine",
issn = "0091-7435",
publisher = "Academic Press Inc.",
number = "5",

}

TY - JOUR

T1 - Cost-effectiveness comparison of five interventions to increase mammography screening

AU - Saywell, Robert M.

AU - Champion, Victoria L.

AU - Skinner, Celette Sugg

AU - McQuillen, Diane

AU - Martin, Daniel

AU - Maraj, Maltie

PY - 1999/11

Y1 - 1999/11

N2 - 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.

AB - 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.

KW - Compliance rates

KW - Cost-effectiveness

KW - Mammography screening

UR - http://www.scopus.com/inward/record.url?scp=0344991689&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344991689&partnerID=8YFLogxK

U2 - 10.1006/pmed.1999.0568

DO - 10.1006/pmed.1999.0568

M3 - Article

C2 - 10564629

AN - SCOPUS:0344991689

VL - 29

SP - 374

EP - 382

JO - Preventive Medicine

JF - Preventive Medicine

SN - 0091-7435

IS - 5

ER -