Cost-Effectiveness of Multiple Interventions
Study Questions
In 2015, the CDC funded the Colorectal Cancer Control Program (CRCCP) to increase colorectal cancer (CRC) screening. The Colorado Department of Public Health and Environment (CDPHE) administered a Clinic Quality Improvement (CQI) initiative in two federally qualified health centers (FQHCs) serving low-income populations.
- Is there improvement in CRC screening uptake?
- How many new patients are up-to-date with CRC screening?
- Can the intervention be implemented cost-effectively in FQHCs?
Intervention and Results
The CQI initiative assesses clinical capacity for CRC screening, modifies processes, and carries out evidence-based interventions (EBIs). For the two FQHCs in this study, CDPHE assessed changes in CRC screening rates and the cost-effectiveness of carrying out EBIs over a 2 year period in FQHC System 1 and over a 3 year period in FQHC System 2.
| FQHCs | EBIs implemented | CRC Screening Rate Increase | New Patients Up-To-Date | Implementation Cost |
|---|---|---|---|---|
| System 1 |
|
18 percentage points |
2,533 patients screened |
$24 per person screened |
| System 2 |
|
10 percentage points |
943 patients screened |
$29 per person screened |
*Example: Strengthening CRC-related policies and procedures
Implications For Public Health
- CRC screening rates increased in FQHCs implementing multiple EBIs as part of the CQI initiative.
- These EBIs can be implemented cost-effectively in FQHCs.
Reference
Lara C, Means K, Morwood K, Lighthall W, Hoover S, Tangka F, French C, Gayle K, DeGroff A, Subramanian S. Colorectal cancer screening interventions in two health care systems serving disadvantaged populations: Screening uptake and cost-effectiveness.External Cancer 2018;124(21),4130–4136.