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Program Costs (program + cost)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Cost-effectiveness of targeted and tailored interventions on colorectal cancer screening use

CANCER, Issue 4 2008
David R. Lairson PhD
Abstract BACKGROUND. Colorectal cancer (CRC) screening is cost-effective but underused. The objective of this study was to determine the cost-effectiveness of targeted and tailored behavioral interventions to increase CRC screening use by conducting an economic analysis associated with a randomized trial among patients in a large, racially and ethnically diverse, urban family practice in Philadelphia. METHODS. The incremental costs per unit increase were measured in individuals who were screened during the 24 months after intervention. Percent increase in screening was adjusted for baseline differences in the study groups. Each intervention arm received a targeted screening invitation letter, stool blood test (SBT) cards, informational booklet, and reminder letter. Tailored interventions incrementally added tailored messages and reminder telephone calls. RESULTS. Program costs of the targeted intervention were $42 per participant. Additional costs of adding tailored print materials and of delivering a reminder telephone call were $150 and $200 per participant, respectively. The cost per additional individual screened was $319 when comparing the no intervention group with the targeted intervention group. CONCLUSIONS. The targeted intervention was more effective and less costly than the tailored intervention. Although tailoring plus reminder telephone call was the most effective strategy, it was very costly per additional individual screened. Mailed SBT cards significantly boosted CRC screening use. However, going beyond the targeted intervention to include tailoring or tailoring plus reminder calls in the manner used in this study did not appear to be an economically attractive strategy. Cancer 2008. © 2007 American Cancer Society. [source]

Cost-effectiveness of extended buprenorphine,naloxone treatment for opioid-dependent youth: data from a randomized trial

ADDICTION, Issue 9 2010
Daniel Polsky
ABSTRACT Aims The objective is to estimate cost, net social cost and cost-effectiveness in a clinical trial of extended buprenorphine,naloxone (BUP) treatment versus brief detoxification treatment in opioid-dependent youth. Design Economic evaluation of a clinical trial conducted at six community out-patient treatment programs from July 2003 to December 2006, who were randomized to 12 weeks of BUP or a 14-day taper (DETOX). BUP patients were prescribed up to 24 mg per day for 9 weeks and then tapered to zero at the end of week 12. DETOX patients were prescribed up to 14 mg per day and then tapered to zero on day 14. All were offered twice-weekly drug counseling. Participants 152 patients aged 15,21 years. Measurements Data were collected prospectively during the 12-week treatment and at follow-up interviews at months 6, 9 and 12. Findings The 12-week out-patient study treatment cost was $1514 (P < 0.001) higher for BUP relative to DETOX. One-year total direct medical cost was only $83 higher for BUP (P = 0.97). The cost-effectiveness ratio of BUP relative to DETOX was $1376 in terms of 1-year direct medical cost per quality-adjusted life year (QALY) and $25 049 in terms of out-patient treatment program cost per QALY. The acceptability curve suggests that the cost-effectiveness ratio of BUP relative to DETOX has an 86% chance of being accepted as cost-effective for a threshold of $100 000 per QALY. Conclusions Extended BUP treatment relative to brief detoxification is cost effective in the US health-care system for the outpatient treatment of opioid-dependent youth. [source]

Does the MBA Experience Support Diversity?

DECISION SCIENCES JOURNAL OF INNOVATIVE EDUCATION, Issue 2 2010
Demographic Effects on Program Satisfaction
ABSTRACT Using data provided by graduates from 128 MBA programs, we examined the extent to which age, gender, and ethnicity predicted student perceptions of the MBA experience. We found that women and minorities were more likely to see program costs and the availability of financial support as significant factors in their program enrollment decisions than were Caucasian males. The most consistent predictor of students' perceptions of their educational experience was whether the MBA program was full time or part time, with full-time programs generally perceived more favorably. Our findings suggest that because diversity measures of age, gender, and ethnicity were not consistent predictors across the different perception areas, at minimum, MBA programs presently do not consistently inhibit diversity. However, given the increasing percentage of women and minorities that comprise the undergraduate population, maintaining the present path in program accessibility may create enrollment problems for MBA programs perhaps in the very near future. Therefore, we conclude with a discussion of the changing demographics in higher education and their potential implications for MBA programs and suggestions for how MBA programs might respond. [source]

Unmet Need Among Rural Medicaid Beneficiaries in Minnesota

THE JOURNAL OF RURAL HEALTH, Issue 3 2002
Sharon K. Long Ph.D.
Given the vulnerabilities of rural residents and the health care issues faced by the Medicaid population generally, the combined effects of being on Medicaid and living in a rural area raise important questions about access to health care services. This study looks at a key dimension of health care access: unmet need for health care services. The study relies on data from a 1998 survey of rural Minnesota Medicaid beneficiaries. An overall response rate of 70% was obtained. For this study, the sample is limited to women who were on Medicaid for the full 12 months prior to the survey, resulting in 900 respondents. The study finds that the rural Medicaid beneficiaries face high levels of unmet need: more than 1 in 3 reported either delaying or not getting doctor, hospital, or specialist care that they felt they needed. Although the study lacks direct measures of the consequences of the high levels of unmet need, there is evidence that greater emergency room use is associated with unmet need. The survey data cannot necessarily be generalized to other rural areas, and like all surveys, this one is subject to nonresponse bias as well as potential biases because of respondent recall and self-assessment of medical needs. Nevertheless, these findings are suggestive of negative consequences of unmet need for both Medicaid beneficiaries and program costs. [source]

Establishing an ED HIV Screening Program: Lessons from the Front Lines

ACADEMIC EMERGENCY MEDICINE, Issue 7 2007
Jeremy Brown MD
In September 2006, the Centers for Disease Control and Prevention released its revised recommendations for human immunodeficiency virus (HIV) testing. Prominent among these were the recommendations that emergency departments should perform routine screening for HIV infection. This report outlines the steps needed to set up an emergency department,based HIV screening program based on these guidelines. It contains the lessons that were learned when such a program was initiated at an academic emergency department. Consideration of these steps will help streamline the establishment of the program, but there should be careful consideration of the program's costs and sustainability before embarking on the process. [source]