Screening for abdominal aortic aneurysms: An analysis of the private and indirect costs in a hospital-based screening program

Abstract

The goal was to determine the private and indirect costs in a hospital based screening programme for abdominal aortic aneurysm (AAA) in five local hospitals in Viborg County, Denmark. As part of a prospective randomized screening program for AAA, all screened 65-year-old men in 1998 were asked to fill in a short questionnaire before leaving the screening location. Data were collected upon work, travelling and time spent. Total private costs were calculated and comparisons was made between the hospitals. All 389 screened patients answered the questionnaire. Only 76 (20%) of the men were still working, and 54 of them had been absent from work an average of 1.5 hours to attend screening, however none of them had suffered pay loss. On average all patients travelled 25 kilometers. The mean travel costs, excluding time spent driving, was 34 DKr per attender. 10% were accompanied to the hospital, but only 1% claimed it was necessary.

The total mean time required for screening was 40 minutes, and the largest part of this time was spent at travelling (35 minutes). The total private and indirect costs including travelling and the estimated production loss were in average 76 DKr per attender. No correlations were found between the extent of private costs and attendance rates at the various screening locations. The private and indirect costs seem to be high compared to the direct cost per scan, and should be considered in the final costs-effectiveness analysis.