Abstract:
:With a low breast cancer incidence and low population density, Greenland is geographically and organisationally challenged in implementing a cost effective breast cancer screening programme where a large proportion of the Greenlandic women will have to travel far to attend. The aim of this paper is to evaluate the cost effectiveness and cost utility of different strategies for implementing population-based breast cancer screening in Greenland. Two strategies were evaluated: Centralised screening in the capital Nuuk and decentralised screening in the five municipal regions of Greenland. A cost effectiveness and cost utility analysis were performed from a societal perspective to estimate the costs per years of life saved and per QALY gained. Two accommodation models for the women's attendance were examined; accommodation in ordinary hotels or in patient hotels. The least costly accommodation model was the hotel model compared with the patient hotel model, regardless of screening strategy. The decentralised strategy was more cost effective compared with the centralised strategy, resulting in 0.5 million DKK per years of life saved (YLS) and 4.1 million DKK per quality-adjusted life year (QALY) gained within the hotel model. These ratios are significantly higher compared with findings from other countries. The sensitivity analysis showed a substantial gap between the most and least favourable model assumptions. The investigated strategies were all estimated to be extremely costly, mostly due to high transportation and accommodation costs and loss of productivity, and none would be accepted as cost-effective per YLS/QALY gained within a conventional threshold level. The least expensive strategy was regional screening with hotel accommodation.
journal_name
Int J Circumpolar Healthjournal_title
International journal of circumpolar healthauthors
Christensen MK,Niclasen BV,Iburg KMdoi
10.1080/22423982.2017.1373580subject
Has Abstractpub_date
2017-01-01 00:00:00pages
1373580issue
1eissn
1239-9736issn
2242-3982journal_volume
76pub_type
杂志文章abstract:OBJECTIVES:Experiences in one's family of origin, especially the relationship to one's parents, supposedly form the basis of relationships in adulthood. The connection between traumatic childhood events and later life has been studied intensively, whereas average childhood growth experiences have been given less attent...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
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journal_title:International journal of circumpolar health
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journal_title:International journal of circumpolar health
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journal_title:International journal of circumpolar health
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journal_title:International journal of circumpolar health
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journal_title:International journal of circumpolar health
pub_type: 杂志文章,多中心研究
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journal_title:International journal of circumpolar health
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更新日期:2011-01-01 00:00:00
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journal_title:International journal of circumpolar health
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doi:10.3402/ijch.v65i1.17889
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journal_title:International journal of circumpolar health
pub_type: 杂志文章
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更新日期:2004-12-01 00:00:00
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更新日期:2017-01-01 00:00:00
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更新日期:2004-01-01 00:00:00