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Cancer. 2013 Aug 1;119 Suppl 15:2855-62. doi: 10.1002/cncr.28158.

Costs of planning and implementing the CDC's Colorectal Cancer Screening Demonstration Program.

Author information

1
RTI International, Waltham, Massachusetts 02451-1623, USA. ssubramanian@rti.org

Abstract

BACKGROUND:

The Centers for Disease Control and Prevention (CDC) initiated the Colorectal Cancer Screening Demonstration Program (CRCSDP) to explore the feasibility of establishing a large-scale colorectal cancer screening program for underserved populations in the United States. The authors of the current report provide a detailed description of the total program costs (clinical and nonclinical) incurred during both the start-up and service delivery (screening) phases of the 4-year program.

METHODS:

Tailored cost questionnaires were completed by staff at the 5 CRCSDP sites. Cost data were collected for clinical services and nonclinical programmatic activities (program management, data collection, and tracking, etc). In-kind contributions also were measured and were assigned monetary values.

RESULTS:

Nearly $11.3 million was expended by the 5 sites over 4 years, and 71% was provided by the CDC. The proportion of funding spent on clinical service delivery and service delivery/patient support comprised the largest proportion of cost during the implementation phase (years 2-4). The per-person nonclinical cost comprised a substantial portion of total costs for all sites. The cost per person screened varied across the 5 sites and by screening method. Overall, economies of scale were observed, with lower costs resulting from larger numbers of individuals screened.

CONCLUSIONS:

Programs incur substantial variable costs related to clinical services and semivariable costs related to nonclinical services. Therefore, programs that serve large populations are likely to achieve a lower cost per person.

KEYWORDS:

cancer screening programs; clinical costs; colorectal cancer; cost assessment; nonclinical costs

PMID:
23868480
DOI:
10.1002/cncr.28158
[Indexed for MEDLINE]
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