Near 100 percent mammagraphy recall compliance costs less than a quarter per patient

The hidden costs of achieving a 99.5% mammography recall compliance rate is 16 cents per screening patient, according to a recent study administered by the radiology department at the University of Michigan in Ann Arbor, MI.

From 2002-2004, 4,025 of 30,286 screening patients were recalled for another mammogram. Out of 4,005 patients, 3,977 returned for a diagnostic study after an average of two phone calls, which averaged 3.65 minutes of total clerical time and cost $1.03 per case (clerical salary + benefits averaged $17 per hour). Forty-eight out of 4,025 initially noncompliant patients received an average of six phone calls, (totaling 4.7 minutes) plus clerical costs for this group of $2.27 with the additional cost of $7.50 for a registered letter, totaling $9.77 per case. Twenty-eight of this group returned for additional screening and the study discovered one of these initially noncompliant patients went on to biopsy revealing a breast cancer.

The total cost for this program was $4,581.84 or $0.16 per screening patient.

"Departments are continually trying to trim waste and eliminate overhead costs in this era of spiraling health costs," said Caroline Blane, MD, lead researcher of the study and radiology department associate chair for clinical services. "We use clerical time to track down noncompliant patients to schedule them and the question arose as to how high was the cost of this clerical time and how much benefit was derived."

"The surprising part was how little it added to the cost of each screening study, 16 cents, to achieve this compliance. As noted in the study, one of the initially noncompliant patients did have an early curable breast cancer which was appropriately treated because we have this safety net and spent the time and so little money getting her to return for a diagnostic mammogram," said Dr. Blane. "If for every 30,000 screening mammograms we pick up one early breast cancer, I believe a delay in diagnosis

Contact: Necoya Lightsey
American Roentgen Ray Society

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