The patient burden of screening mammography recall.

OBJECTIVE: The aim of this article is to evaluate the burden of direct and indirect costs borne by recalled patients after a false positive screening mammogram. METHODS: Women aged 40-75 years undergoing screening mammography were identified from a U.S. commercial claims database. Women were required to have 12 months pre- and 6 months post-index enrollment to identify utilization and exclude patients with subsequent cancer diagnoses. Recall was defined as the use of diagnostic mammography or breast ultrasound during 6 months post-index. Descriptive statistics were presented for recalled and non-recalled patients; differences were compared using the chi square test. Out-of-pocket costs were totaled by utilization type and in aggregate for all recall utilization. RESULTS: Of 1,723,139 patients with a mammography screening that were not diagnosed with breast cancer, 259,028 (15.0%) were recalled. Significant demographic differences were observed between recalled and non-recalled patients. The strongest drivers of patient costs were image-guided biopsy (mean $351 among 11.8$50; 80.1%), and ultrasound ($58; 65.7%), which accounted for 29.9%, 29.0%, and 27.5% of total recall costs, respectively. For many patients the entire cost of recall utilization was covered by the health plan. Total costs were substantially greater among patients with biopsy; one-third of all patients experienced multiple days of recall utilization. CONCLUSION: After a false positive screening mammography, recalled women incurred both direct medical costs and indirect time costs. The cost burden for women with employer-based insurance was dependent upon the type of utilization and extent of health plan coverage. Additional research and technologies are needed to address the entirety of the recall burden in diverse populations of women

Understanding patient options, utilization patterns, and burdens associated with breast cancer screening.

Abstract Despite ongoing awareness, educational campaigns, and advances in technology, breast cancer screening remains a complex topic for women and for the health care system. Lack of consensus among organizations developing screening guidelines has caused confusion for patients and providers. The psychosocial factors related to breast cancer screening are not well understood. The prevailing algorithm for screening results in significant rates of patient recall for further diagnostic imaging or procedures, the majority of which rule out breast cancer rather than confirming it. For women, the consequences of the status quo range from unnecessary stress to additional out-of-pocket expenses to indirect costs that are more difficult to quantify. A more thoughtful approach to breast cancer screening, coupled with a research agenda that recognizes the indirect and intangible costs that women bear, is needed to improve cost and quality outcomes in this area

Working With JCPH Doctoral Students

This webinar contains information for TJU faculty on how to support and mentor doctoral students in the Jefferson College of Population Health

10 Years of Progress in Population Health: Connecting Health and Healthcare

Table of Contents 6 - A City of Firsts, A College of Firsts 8 - Upstream & Downstream 14 - Innovations in Education 16 - Equipped with the Tools 17 - Working Towards Community Health at a Population Level 18 - Community Health Requires Community Partnership 19 - Bridging the Academic-Industry Divide 20 - The Center for Population Health Innovation Supports Lifelong Learning 22 - Investing in Research, Investing in Health 23 - 1989 Jefferson Center for Population Health 24 - Research in Actio