The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population

Robert M. Saywell, Victoria Champion, Terrell W. Zollinger, Maltie Maraj, Celette Sugg Skinner, Kathleen A. Zoppi, Carolyn M. Muegge

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: To determine the cost effectiveness of 5 combinations of strategies for increasing adherence to mammography recommendations in a population of women between the ages of 50 and 85 years enrolled in a large midwestern health maintenance organization. Study design: A randomized control trial comparing interventions believed to increase mammography adherence. Patients and methods: Intervention strategies included 5 combinations of physician recommendation, telephone, and in-person counseling. A total of 652 participants were randomly assigned to 1 of 6 intervention groups and 628 (95.9%) were available at 6-month follow-up. A logistic regression model with adherence as the dependent variable and group as the independent variable was used to test for significant differences between groups. A ratio of cost to improvement in mammogram adherence evaluated the cost effectiveness at 6 months. Results: All 5 interventions resulted in significantly higher rates of adherence compared to no intervention. However, when considering costs, only 1 emerged as the superior strategy for the overall study population. In-person counseling was the most cost-effective strategy overall, followed closely by in-person counseling and physician's letter intervention. For women contemplating mammography, the telephone contact and physician's letter combination was the most cost-effective intervention. For women not contemplating mammography, the physician's letter was superior. The physician's letter worked best with women who had previous mammograms. For women with no mammogram history, the in-person counseling and physician's letter combination was clearly superior. Conclusions: The cost effectiveness of mammography screening interventions varies based on women's prior history of mammograms and their future intent. Further, managed care organization member characteristics can be used to determine the most cost-effective mammography screening intervention based on individual readiness.

Original languageEnglish
Pages (from-to)33-44
Number of pages12
JournalAmerican Journal of Managed Care
Volume9
Issue number1
StatePublished - Jan 1 2003

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Managed Care Programs
Mammography
managed care
Cost-Benefit Analysis
Physicians
Counseling
physician
Costs and Cost Analysis
costs
Population
counseling
Telephone
human being
Logistic Models
telephone
Health Maintenance Organizations
organization
Group
intervention strategy
History

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Saywell, R. M., Champion, V., Zollinger, T. W., Maraj, M., Skinner, C. S., Zoppi, K. A., & Muegge, C. M. (2003). The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population. American Journal of Managed Care, 9(1), 33-44.

The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population. / Saywell, Robert M.; Champion, Victoria; Zollinger, Terrell W.; Maraj, Maltie; Skinner, Celette Sugg; Zoppi, Kathleen A.; Muegge, Carolyn M.

In: American Journal of Managed Care, Vol. 9, No. 1, 01.01.2003, p. 33-44.

Research output: Contribution to journalArticle

Saywell, RM, Champion, V, Zollinger, TW, Maraj, M, Skinner, CS, Zoppi, KA & Muegge, CM 2003, 'The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population', American Journal of Managed Care, vol. 9, no. 1, pp. 33-44.
Saywell, Robert M. ; Champion, Victoria ; Zollinger, Terrell W. ; Maraj, Maltie ; Skinner, Celette Sugg ; Zoppi, Kathleen A. ; Muegge, Carolyn M. / The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population. In: American Journal of Managed Care. 2003 ; Vol. 9, No. 1. pp. 33-44.
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