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- Yan Li, Erin Carlson, Roberto Villarreal, Leah Meraz, and José A Pagán.
- Center for Health Innovation, The New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029. E-mail: yli@nyam.org.
- Am J Manag Care. 2017 Jul 1; 23 (7): 429-434.
ObjectivesTo assess the cost-effectiveness of a community-based patient navigation program to improve cervical cancer screening among Hispanic women 18 or older in San Antonio, Texas.Study DesignWe used a microsimulation model of cervical cancer to project the long-term cost-effectiveness of a community-based patient navigation program compared with current practice.MethodsWe used program data from 2012 to 2015 and published data from the existing literature as model input. Taking a societal perspective, we estimated the lifetime costs, life expectancy, and quality-adjusted life-years and conducted 2-way sensitivity analyses to account for parameter uncertainty.ResultsThe patient navigation program resulted in a per-capita gain of 0.2 years of life expectancy. The program was highly cost-effective relative to no intervention (incremental cost-effectiveness ratio of $748). The program costs would have to increase up to 10 times from $311 for it not to be cost-effective.ConclusionsThe 3-year community-based patient navigation program effectively increased cervical cancer screening uptake and adherence and improved the cost-effectiveness of the screening program for Hispanic women 18 years or older in San Antonio, Texas. Future research is needed to translate and disseminate the patient navigation program to other socioeconomic and demographic groups to test its robustness and design.
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