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Near 100% Mammography Recall Compliance Costs Less than a Quarter Per Patient
Ann Arbor - The hidden costs of achieving a 99.5 percent mammography recall compliance rate is 16 cents per screening patient, according to a recent study administered by researchers at the University of Michigan Comprehensive Cancer Center.
From 2002-2004, 4,025 of 30,286 screening patients were recalled for another mammogram. Out of 4,005 patients, 3,977 returned for a diagnostic study after an average of two phone calls, which averaged 3.65 minutes of total clerical time and cost $1.03 per case (clerical salary + benefits averaged $17 per hour). Forty-eight out of 4,025 initially noncompliant patients received an average of six phone calls, (totaling 4.7 minutes) plus clerical costs for this group of $2.27 with the additional cost of $7.50 for a registered letter, totaling $9.77 per case. Twenty-eight of this group returned for additional screening and the study discovered one of these initially noncompliant patients went on to biopsy revealing a breast cancer.
The total cost for this program was $4,581.84 or $0.16 per screening patient.
“Departments are continually trying to trim waste and eliminate overhead costs in this era of spiraling health costs,” says Caroline Blane, M.D., lead researcher of the study and associate chair for clinical services at the U-M Department of Radiology. “We use clerical time to track down noncompliant patients to schedule them and the question arose as to how high was the cost of this clerical time and how much benefit was derived.
“The surprising part was how little it added to the cost of each screening study, 16 cents, to achieve this compliance. As noted in the study, one of the initially noncompliant patients did have an early curable breast cancer which was appropriately treated because we have this safety net and spent the time and so little money getting her to return for a diagnostic mammogram,” says Blane. “If for every 30,000 screening mammograms we pick up one early breast cancer, I believe a delay in diagnosis of this one breast cancer would have cost considerably more in the long run than the 16 cents per screening mammogram. Not only are we providing a patient service with improved patient outcome but we are probably also saving health care dollars.”
The full results of this study will be presented on Thursday, May 4, 2006 during the American Roentgen Ray Society Annual Meeting in Vancouver, British Columbia.
Written by: Necoya Lightsey 703-858-4304; Keri Sperry 703-858-4306.
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