The costs of reducing loss to follow-up in South African cervical cancer screening

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dc.contributor.authorGoldhaber-Fiebert, Jeremyen_ZA
dc.contributor.authorDenny, Lynetteen_ZA
dc.contributor.authorDe Souza, Michelleen_ZA
dc.contributor.authorWright, Thomasen_ZA
dc.contributor.authorKuhn, Louiseen_ZA
dc.contributor.authorGoldie, Sueen_ZA
dc.date.accessioned2015-10-28T07:00:06Z
dc.date.available2015-10-28T07:00:06Z
dc.date.issued2005en_ZA
dc.description.abstractBACKGROUND:This study was designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting. METHODS: Women were enrolled in this Cape Town, South Africa-based screening study between 2000 and 2003, and all had scheduled follow-up visits in 2003. Community health worker (CHW) time, vehicle use, maintenance, and depreciation were estimated from weekly logs and cost accounting systems. The percentage of women who attended their scheduled visit, those who attended after CHW contact(s), and those who never returned despite attempted contact(s) were determined. The number of CHW visits per woman was also estimated. RESULTS: 3,711 visits were scheduled in 2003. Of these, 2,321 (62.5%) occurred without CHW contact, 918 (24.8%) occurred after contact(s), and 472 (12.7%) did not occur despite contact(s). Loss to follow-up was reduced from 21% to 6%, 39% to 10%, and 50% to 24% for 6, 12, and 24-month visits. CHWs attempted 3,200 contacts in 530 trips. On average, 3 CHWs attempted to contact 6 participants over each 111 minute trip. The per-person cost (2003 Rand) for these activities was 12.75, 24.92, and 40.50 for 6, 12, and 24-month visits. CONCLUSION: CHW contact with women who missed scheduled visits increased their return rate. Cost-effectiveness analyses aimed at policy decisions about cervical cancer screening in developing countries should incorporate these findings.en_ZA
dc.identifier.apacitationGoldhaber-Fiebert, J., Denny, L., De Souza, M., Wright, T., Kuhn, L., & Goldie, S. (2005). The costs of reducing loss to follow-up in South African cervical cancer screening. <i>Cost Effectiveness and Resource Allocation</i>, http://hdl.handle.net/11427/14447en_ZA
dc.identifier.chicagocitationGoldhaber-Fiebert, Jeremy, Lynette Denny, Michelle De Souza, Thomas Wright, Louise Kuhn, and Sue Goldie "The costs of reducing loss to follow-up in South African cervical cancer screening." <i>Cost Effectiveness and Resource Allocation</i> (2005) http://hdl.handle.net/11427/14447en_ZA
dc.identifier.citationGoldhaber-Fiebert, J. D., Denny, L. E., De Souza, M., Wright Jr, T. C., Kuhn, L., & Goldie, S. J. (2005). The costs of reducing loss to follow-up in South African cervical cancer screening. Cost effectiveness and resource allocation: C/E, 3, 11-11.en_ZA
dc.identifier.ris TY - Journal Article AU - Goldhaber-Fiebert, Jeremy AU - Denny, Lynette AU - De Souza, Michelle AU - Wright, Thomas AU - Kuhn, Louise AU - Goldie, Sue AB - BACKGROUND:This study was designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting. METHODS: Women were enrolled in this Cape Town, South Africa-based screening study between 2000 and 2003, and all had scheduled follow-up visits in 2003. Community health worker (CHW) time, vehicle use, maintenance, and depreciation were estimated from weekly logs and cost accounting systems. The percentage of women who attended their scheduled visit, those who attended after CHW contact(s), and those who never returned despite attempted contact(s) were determined. The number of CHW visits per woman was also estimated. RESULTS: 3,711 visits were scheduled in 2003. Of these, 2,321 (62.5%) occurred without CHW contact, 918 (24.8%) occurred after contact(s), and 472 (12.7%) did not occur despite contact(s). Loss to follow-up was reduced from 21% to 6%, 39% to 10%, and 50% to 24% for 6, 12, and 24-month visits. CHWs attempted 3,200 contacts in 530 trips. On average, 3 CHWs attempted to contact 6 participants over each 111 minute trip. The per-person cost (2003 Rand) for these activities was 12.75, 24.92, and 40.50 for 6, 12, and 24-month visits. CONCLUSION: CHW contact with women who missed scheduled visits increased their return rate. Cost-effectiveness analyses aimed at policy decisions about cervical cancer screening in developing countries should incorporate these findings. DA - 2005 DB - OpenUCT DO - 10.1186/1478-7547-3-11 DP - University of Cape Town J1 - Cost Effectiveness and Resource Allocation LK - https://open.uct.ac.za PB - University of Cape Town PY - 2005 T1 - The costs of reducing loss to follow-up in South African cervical cancer screening TI - The costs of reducing loss to follow-up in South African cervical cancer screening UR - http://hdl.handle.net/11427/14447 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14447
dc.identifier.urihttp://dx.doi.org/10.1186/1478-7547-3-11
dc.identifier.vancouvercitationGoldhaber-Fiebert J, Denny L, De Souza M, Wright T, Kuhn L, Goldie S. The costs of reducing loss to follow-up in South African cervical cancer screening. Cost Effectiveness and Resource Allocation. 2005; http://hdl.handle.net/11427/14447.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2005 Goldhaber-Fiebert et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceCost Effectiveness and Resource Allocationen_ZA
dc.source.urihttp://www.resource-allocation.comen_ZA
dc.subject.otherObstetrics and Gynecology, Medical screening, Cervical cancer, Medical appointmentsen_ZA
dc.subject.otherschedules, Medical care costs, Community health aidesen_ZA
dc.titleThe costs of reducing loss to follow-up in South African cervical cancer screeningen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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