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167 COLONOSCOPY AND FLEXIBLE SIGMOIDOSCOPY: A MICROCOSTING STUDY EVALUATING DIAGNOSTIC PROCEDURAL COSTS IN AN OUTPATIENT ENDOSCOPY CLINIC JC Sambrook1, W Chui1, H Wang1, AR Levy1, RA Enns2, M Choi3, L Lo3, D Chan3 AIMS: Determining cost-effective screening strategies for colorectal cancer (CRC) is growing in importance with the availability of several screening tools. However, few published data are available on the costs of these procedures in Canada. The goal of this study was to estimate the per procedure cost of two CRC screening strategies, conventional colonoscopy (COL) and flexible sigmoidoscopy (SIG) at St Paul's Hospital outpatient endoscopy clinic in Vancouver.
1Oxford Outcomes Ltd, Vancouver, British Columbia; 2Dept of Gastroenterology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia; 3University of Toronto, Toronto, Ontario
METHODS: A time-and-motion study was carried out on 117 COL and 55 SIG procedures between July and October 2004. We estimated the direct medical costs including: nursing and physician time (in min) spent per EGD episode beginning with patient registration and ending with patient discharge postprocedure; and resources expended, including supplies and medications. We applied unit costs and nursing wages from SPH and provincial physician fees. All values are reported in 2004 Canadian dollars and exclude overhead and indirect costs.
RESULTS: Mean age of patients was 57 years (22; 89) for COL and 54 years (21; 90) for SIG. Total time for COL was 182 (60; 317) minutes of which the duration of the procedure was 34 min (18; 60). For SIG, total time was 53 min (14; 110), of which procedure time alone was 15 min (7; 44). The total overall cost was $158 ($65; $471) for COL and $31 ($14; $86) for SIG. For resources consumed, the average costs were $53 for COL and $14 for SIG, of which drugs costs were $14 ($1; $59) and $1 ($0; $24) for COL and SIG respectively. Labour accounted for $99 ($27; $177) for COL and $11 ($5; $25) for SIG.
CONCLUSIONS: These costs of screening procedures are accurate estimates of COL/SIG procedures in Canada, are useful for inclusion in economic evaluation of CRC screening in Canada.