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Abstract
Highlights
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- An innovative 2-1-1 call center-based cancer control navigator program.
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- Evaluate annual total and per participant cost of implementing and maintaining program in metropolitan areas.
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- Identify the components of cost and the effects of scale of operations.
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- Assess the participant time cost and define the variation in participant time cost.
Objectives
Methods
Social
service call centers in Houston and Weslaco, TX, assessed cancer risks
and implemented cancer screening promotion and navigation. Micro costing
was used to estimate the program costs. Staff logs and call records
tracked personnel time and material costs, including a standard 30%
overhead rate. Sensitivity analysis examined the effect of varying
uncertain cost parameters. Scale effects were simulated for larger
population coverage.
Results
The
total cost to recruit and navigate 732 persons, out of 2933 individuals
who called the center was $215,847. The participant time cost was
$19,503, and the personnel cost was $116,523. The cost per navigated
participant was $295 (95% CI, $290.56–$298.07). The average cost per
participant for recruitment and referral only, was $36 (95% CI,
$34.9–$36.9). Average cost declines to $34 for recruitment and referral,
and to $225 for recruitment, referral, and navigation when the number
of participants increases to 15,000 individuals.
Conclusions
Expanding
2-1-1 referral services with opportunistic cancer screening promotion
takes advantage of existing infrastructure but requires substantial
additional staff time, participant time, and budget. Cost estimation is
the first step in a full economic evaluation and informs program
planners and decision-makers on the resource and budgetary requirements
of this innovative strategy for increasing cancer screening in low
income communities.
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