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Colorectal cancer screening interventions in 2 health care systems serving disadvantaged populations: Screening uptake and cost‐effectiveness
Author(s) -
Lara Christen L.,
Means Kelly L.,
Morwood Krystal D.,
Lighthall Westley R.,
Hoover Sonja,
Tangka Florence K.L.,
French Cynthia,
Gayle Krystal D.,
DeGroff Amy,
Subramanian Sujha
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31691
Subject(s) - medicine , psychological intervention , public health , health care , population health , disadvantaged , cost effectiveness , population , environmental health , cancer screening , family medicine , gerontology , nursing , cancer , risk analysis (engineering) , political science , law , economics , economic growth
Background The objectives of the current study were to assess changes in colorectal cancer (CRC) screening uptake and the cost‐effectiveness of implementing multiple evidence‐based interventions (EBIs). EBIs were implemented at 2 federally qualified health centers that participated in the Colorado Department of Public Health and Environment’s Clinic Quality Improvement for Population Health initiative. Methods Interventions included patient and provider reminder systems (health system 1), provider assessment and feedback (health systems 1 and 2), and numerous support activities (health systems 1 and 2). The authors evaluated health system 1 from July 2013 to June 2015 and health system 2 from July 2014 to June 2017. Evaluation measures included annual CRC screening uptake, EBIs implemented, funds received and expended by each health system to implement EBIs, and intervention costs to the Colorado Department of Public Health and Environment and health systems. Results CRC screening uptake increased by 18 percentage points in health system 1 and 10 percentage points in health system 2. The improvements in CRC screening uptake, not including the cost of the screening tests, were obtained at an added cost ranging from $24 to $29 per person screened. Conclusions In both health systems, the multicomponent interventions implemented likely resulted in improvements in CRC screening. The results suggest that significant increases in CRC screening uptake can be achieved in federally qualified health centers when appropriate technical support and health system commitment are present. The cost estimates of the multicomponent interventions suggest that these interventions and support activities can be implemented in a cost‐effective manner.