Costs and cost-effectiveness of a clinical intervention to increase mammography utilization in an inner city public health hospital

Prev Med. 2002 Jul;35(1):87-96. doi: 10.1006/pmed.2002.1046.


Background: Studies have demonstrated the cost-effectiveness of screening women for breast cancer; however, the cost-effectiveness of strategies to motivate women to receive breast cancer screening has been less well studied.

Methods: A total of 196 women, aged 50 to 74, who were enrolled in a public health hospital clinic, were noncompliant with mammography screening, and had at least one routine clinic appointment during the study period (15 months) were entered into a randomized, controlled trial of a motivational intervention to increase mammography rates. Costs were captured via a modified Delphi technique, accounting records, sampling of staff time logs, and an estimation of miscellaneous and overhead costs. Summary costs were calculated using Excel spread sheets.

Results: Overall, 49% of women who received the intervention had a mammogram within 8 weeks of an index visit compared with 22% of control women. Calculation of the cost-effectiveness of the project showed an additional cost of $151 (1996 U.S.$) for each woman receiving the intervention and $559 for each additional woman motivated to receive a mammogram.

Conclusions: Cost tracking and cost-effectiveness analysis can be done when intervening in a clinical setting, thereby allowing clinics to make informed decisions about implementing programs to increase motivation of their patients to receive screening.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / prevention & control*
  • Breast Neoplasms / psychology
  • Costs and Cost Analysis
  • Female
  • Hospitals, Public / economics
  • Hospitals, Urban / economics
  • Humans
  • Mammography / economics*
  • Mammography / psychology
  • Mammography / statistics & numerical data*
  • Mass Screening / economics*
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Models, Economic
  • Motivation
  • Patient Compliance / psychology
  • Program Evaluation