I would like assistance with problem 11-2

EXERCISES

Use the following information to do a cost-effectiveness analysis of a work site screening program:

Factor A is an early predictor of Disease 47, a serious health problem, and it is measurable by a blood test. As the level of Factor A increases, the risk of contracting Disease 47 increases, particularly for individuals with values of Factor A greater than 350 mg per deciliter of blood.

Disease 47 treatment is expensive. For example, a death from the disease costs $45,000 and a nonfatal case costs $94,000 on average. For purposes of this analysis, assume that the expected lifetime benefits from averting Disease 47 for persons less than 60 years old, who lowers their level of Factor A by 5% are equal to a present value of $83.

This figure represents the present value of health care dollars saved as a result of cases of Disease 47 averted in the population lowering their Factor by 5%. Most individuals do not suffer from Disease 47 so the average cost saved over many people is quite low. These lifetime costs can be compared to the costs of an intervention to lower Factor A.

One way of reducing the costs of prevention interventions is to provide an intervention at the work site. This would consist of two parts: 1) initial screening for all participants; and 2) a special intervention for those whose Factor A is founc to be 350mg/dl or greater.

Table 11.1 Factor A Initial Screening Program Resources (per screener) for each screening Session

Preparation Time	12.4
Travel Time to/From Site	6.4
Follow-up Time	7.8
Average Number of Screenees Per Session	250
Supply Costs	$1000.00
Mail/Phone	$150.00
Average Salary of Screener Including Fringes	$65,000
Annual Hours Worked Per Screener	$2080
Number of Screeners	4

Costs for the special intervention were calculated to be $75 per individual receiving the intervention.

Effects on Factor A, obtained from the baseline and 12-month rescreening of all program participants whose initial values were 350 mg/dl or greater were:

Initial Screening Only 1.9% reduction

Initial Plus Special Intervention 5.3%

The first step is to compute the cost for each screener per hour.

Screener Cost per Hour = Average Salary of Screener/Hours Worked by Screener =

$65,000/2080 = $31.25/hour

To answer the questions below the first step is to creat a table to determine per screener cost for program.

Activity	Cost Per Unit	# of units	Total Cost
Prep Time	31.25/hour	12.4	387.50
Travel Time	31.25/hour	1.3	40.63
Time On-site	31.25/hour	6.4	200.00
Follow Up Time	31.25/hour	7.8	243.75
Supply Costs			1000.00
Mail/Phone			150.00
Total Costs per Screener			2,021

With 4 screeners, the total cost for screeners = $2,021.88 * 4 = $8,087.52

11-1

How much did it cost, per person screened for the initial Factor A testing. NOTE: Screeners get paid for their travel time.

11-2

How much did it cost for each person who participated in the special intervention as well as the initial screening?

Costs for the special intervention were calculated to be $75 per individual receiving the

l intervention for those whose Factor A is found to be 350 mg/dl or greater. The data in Table 11.1 represent the costs for an initial Factor A screening program.