A cost analysis of colonoscopy using microcosting and time-and-motion techniques

Stephen G Henry, Reid M. Ness, Renée A. Stiles, Ayumi K. Shintani, Robert S. Dittus

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

BACKGROUND: The cost of an individual colonoscopy is an important determinant of the overall cost and cost-effectiveness of colorectal cancer screening. Published cost estimates vary widely and typically report institutional costs derived from gross-costing methods. OBJECTIVE: Perform a cost analysis of colonoscopy using micro-costing and time-and-motion techniques to determine the total societal cost of colonoscopy, which includes direct health care costs as well as direct non-health care costs and costs related to patients' time. The design is prospective cohort. The participants were 276 contacted, eligible patients who underwent colonoscopy between July 2001 and June 2002, at either a Veterans' Affairs Medical Center or a University Hospital in the Southeastern United States. MAJOR RESULTS: The median direct health care cost for colonoscopy was $379 (25%, 75%; $343, $433). The median direct non-health care and patient time costs were $226 (25%, 75%; $187, $323) and $274 (25%, 75%; $186, $368), respectively. The median total societal cost of colonoscopy was $923 (25%, 75%; $805, $1047). The median direct health care, direct non-health care, patient time costs, and total costs at the VA were $391, $288, $274, and $958, respectively; analogous costs at the University Hospital were $376, $189, $368, and $905, respectively. CONCLUSION: Microcosting techniques and time-and-motion studies can produce accurate, detailed cost estimates for complex medical interventions. Cost estimates that inform health policy decisions or cost-effectiveness analyses should use total costs from the societal perspective. Societal cost estimates, which include patient and caregiver time costs, may affect colonoscopy screening rates.

Original languageEnglish (US)
Pages (from-to)1415-1421
Number of pages7
JournalJournal of General Internal Medicine
Volume22
Issue number10
DOIs
StatePublished - Oct 2007
Externally publishedYes

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Colonoscopy
Costs and Cost Analysis
Health Care Costs
Cost-Benefit Analysis
Patient Care
Southeastern United States
Time and Motion Studies
Veterans
Health Policy
Early Detection of Cancer

Keywords

  • Colonoscopy
  • Colorectal cancer
  • Cost analysis
  • Microcosting
  • Time-and-motion

ASJC Scopus subject areas

  • Internal Medicine

Cite this

A cost analysis of colonoscopy using microcosting and time-and-motion techniques. / Henry, Stephen G; Ness, Reid M.; Stiles, Renée A.; Shintani, Ayumi K.; Dittus, Robert S.

In: Journal of General Internal Medicine, Vol. 22, No. 10, 10.2007, p. 1415-1421.

Research output: Contribution to journalArticle

Henry, Stephen G ; Ness, Reid M. ; Stiles, Renée A. ; Shintani, Ayumi K. ; Dittus, Robert S. / A cost analysis of colonoscopy using microcosting and time-and-motion techniques. In: Journal of General Internal Medicine. 2007 ; Vol. 22, No. 10. pp. 1415-1421.
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abstract = "BACKGROUND: The cost of an individual colonoscopy is an important determinant of the overall cost and cost-effectiveness of colorectal cancer screening. Published cost estimates vary widely and typically report institutional costs derived from gross-costing methods. OBJECTIVE: Perform a cost analysis of colonoscopy using micro-costing and time-and-motion techniques to determine the total societal cost of colonoscopy, which includes direct health care costs as well as direct non-health care costs and costs related to patients' time. The design is prospective cohort. The participants were 276 contacted, eligible patients who underwent colonoscopy between July 2001 and June 2002, at either a Veterans' Affairs Medical Center or a University Hospital in the Southeastern United States. MAJOR RESULTS: The median direct health care cost for colonoscopy was $379 (25{\%}, 75{\%}; $343, $433). The median direct non-health care and patient time costs were $226 (25{\%}, 75{\%}; $187, $323) and $274 (25{\%}, 75{\%}; $186, $368), respectively. The median total societal cost of colonoscopy was $923 (25{\%}, 75{\%}; $805, $1047). The median direct health care, direct non-health care, patient time costs, and total costs at the VA were $391, $288, $274, and $958, respectively; analogous costs at the University Hospital were $376, $189, $368, and $905, respectively. CONCLUSION: Microcosting techniques and time-and-motion studies can produce accurate, detailed cost estimates for complex medical interventions. Cost estimates that inform health policy decisions or cost-effectiveness analyses should use total costs from the societal perspective. Societal cost estimates, which include patient and caregiver time costs, may affect colonoscopy screening rates.",
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