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Collecting Direct Non-Health Care and Time Cost Data: Application to Screening and Diagnosis of Cervical Cancer

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  • Scott B. Cantor

    (Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, sbcantor@mdanderson.org)

  • Lawrence B. Levy

    (Department of Radiation Oncology Treatment, The University of Texas M. D. Anderson Cancer Center, Houston)

  • Marylou Cárdenas-Turanzas

    (Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston)

  • Karen Basen-Engquist

    (Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston)

  • Tao Le

    (Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston)

  • J. Robert Beck

    (Department of Information Technology, Fox Chase Cancer Center, Philadelphia)

  • Michele Follen

    (Biomedical Engineering Center, The University of Texas M. D. Anderson Cancer Center, Houston)

Abstract

Background . Data on direct non-health care and time costs are rarely collected, though the incorporation of such data is essential for performing cost-effectiveness analyses according to established guidelines. Objectives . To explore the challenges involved in collecting and analyzing these data from patients enrolled in a clinical trial. Methods . Through the use of a pilot study, the authors designed a questionnaire to collect these costs. They used this questionnaire in a clinical trial conducted at a comprehensive cancer center and a public community hospital. Patients in the trial were undergoing screening or diagnostic procedures through a clinical protocol designed to measure the effectiveness of fluorescence and reflectance spectroscopy for detecting cervical precancers. Direct non-health care costs were adjusted to 2003 constant dollars. Results . The authors successfully collected direct non-health care and time cost data, thus demonstrating the feasibility of acquiring such data. Compared to patients receiving diagnostic services for cervical cancer, those receiving screening services for the same condition in both settings incurred lower direct non-health care costs and time costs, as defined in the questionnaire. Compared to patients receiving either service at the comprehensive cancer center, those seeking either service at the public community hospital incurred lower direct non-health care costs and time costs. When outliers were removed, total direct non-health care costs and time costs substantially decreased for diagnostic patients in the comprehensive cancer center; total direct non-health care costs and time costs for other subgroups remained essentially unchanged. Conclusions . Direct non-health care and time cost data can be collected within a large-scale clinical trial. The setting (community v. specialty hospital) and population (patients receiving screening v. diagnostic examination) makes a difference regarding the cost totals. The order of magnitude of the final result depends on the context in which the non-health care and time cost data will be used.

Suggested Citation

  • Scott B. Cantor & Lawrence B. Levy & Marylou Cárdenas-Turanzas & Karen Basen-Engquist & Tao Le & J. Robert Beck & Michele Follen, 2006. "Collecting Direct Non-Health Care and Time Cost Data: Application to Screening and Diagnosis of Cervical Cancer," Medical Decision Making, , vol. 26(3), pages 265-272, May.
    • Handle: RePEc:sae:medema:v:26:y:2006:i:3:p:265-272
    DOI: 10.1177/027298906288679
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    References listed on IDEAS

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    1. Milton C. Weinstein & Joanna E. Siegel & Alan M. Garber & Joseph Lipscomb & Bryan R. Luce & Willard G. Manning & George W. Torrance, 1997. "Productivity costs, time costs and health‐related quality of life: a response to the Erasmus Group," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 505-510, September.
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    1. Daniel E. Jonas & Louise B. Russell & Jon Chou & Michael Pignone, 2010. "Willingness‐to‐pay to avoid the time spent and discomfort associated with screening colonoscopy," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1193-1211, October.
    2. Daniel E. Jonas & Louise B. Russell & Robert S. Sandler & Jon Chou & Michael Pignone, 2008. "Value of Patient Time Invested in the Colonoscopy Screening Process: Time Requirements for Colonoscopy Study," Medical Decision Making, , vol. 28(1), pages 56-65, January.
    3. Emmanouil Mentzakis & Paul McNamee & Mandy Ryan & Matthew Sutton, 2012. "Valuing Informal Care Experience: Does Choice of Measure Matter?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 108(1), pages 169-184, August.

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