Carter A P, Thompson R S, Bourdeau R V, Andenes J, Mustin H, Straley H
Prev Med. 1987 Jan;16(1):19-34. doi: 10.1016/0091-7435(87)90003-x.
The logistics of complying with current American Cancer Society breast cancer screening recommendations in a large health maintenance organization, serving more than 50,000 women age 40 or older, are described. An alternative screening approach estimated to be at least as health-effective as the American Cancer Society recommendations has been developed and appears to solve the problem and is financially feasible. Cost-effectiveness depends on optimal use of mammography and health-care personnel resources. The authors show how the start-up and maintenance costs of an organized program can be offset by future cost savings resulting from reduced long-term disability in patients diagnosed at Stages 0-1 as opposed to Stages 2 and later. Careful selection of the delivery model before implementation can make a breast cancer screening program cost-effective as well as health-effective.
本文描述了一家为超过5万名40岁及以上女性提供服务的大型健康维护组织中，遵循美国癌症协会乳腺癌筛查建议的后勤工作。已开发出一种替代筛查方法，估计其健康效果至少与美国癌症协会的建议相同，该方法似乎解决了问题且在财务上可行。成本效益取决于乳房X光检查和医疗保健人员资源的最佳利用。作者表明，与2期及更晚期诊断的患者相比，0-1期诊断的患者长期残疾减少，由此带来的未来成本节省可以抵消有组织项目的启动和维护成本。在实施前仔细选择交付模式，可以使乳腺癌筛查项目既具有成本效益又具有健康效益。
