PubMed · 1389594
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P N Ridge. 1992-09-05. Fee crisis.. https://doi.org/10.1038/sj.bdj.4807962
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This paper presents the first full micro costing of a commonly used cancer genetic counselling and testing protocol used in the UK. Costs were estimated for the Cardiff clinic of the Cancer Genetics Service in Wales by issuing a questionnaire to all staff, conducting an audit of clinic rooms and equipment and obtaining gross unit costs from the finance department. A total of 22 distinct event pathways were identified for patients at risk of developing breast, ovarian, breast and ovarian or colorectal cancer. The mean cost per patient were pound sterling 97- pound sterling 151 for patients at moderate risk, pound sterling 975- pound sterling 3072 for patients at high risk of developing colorectal cancer and pound sterling 675- pound sterling 2909 for patients at high risk of developing breast or ovarian cancer. The most expensive element of cancer genetic services was labour. Labour costs were dependent upon the amount of labour, staff grade, number of counsellors used and the proportion of staff time devoted to indirect patient contact. With the growing demand for cancer genetic services and the growing number of national and regional cancer genetic centers, there is a need for the different protocols being used to be thoroughly evaluated in terms of costs and outcomes.
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AIMS: Universal Newborn Hearing Screening (UNHS) is being implemented worldwide as an effective method of early identification of hearing loss. The impact of delayed detection of sensorineural hearing loss is a major lifelong impairment. The aim of the study was to assess the feasibility of introducing universal newborn hearing screening over the 12-month period in the Neonatal Intensive Care Unit (NICU) at Christchurch Women's Hospital, and to assess the costs, and resources required. METHODS: Universal Newborn Hearing Screening was conducted over a 12 month period in the Neonatal Service of Christchurch Women's Hospital. Throughout the implementation period, data were collected to monitor and benchmark against World's best practice. RESULTS: During the 12 months of the study, 435 babies were screened for hearing loss in the Neonatal Service at Christchurch Women's Hospital. Of these babies, 19 (4.37%) were referred for diagnostic 'auditory brainstem response' ABR testing to confirm hearing loss. Two babies were confirmed with hearing loss, with only one baby exhibiting a known risk factor for deafness. This resulted in a positive predictive index of 10.53%. CONCLUSIONS: This study highlights that UNHS can be implemented efficiently and cost-effectively within the Neonatal Service of a New Zealand Hospital. The results were consistent with best practice, and show the benefits of UNHS against 'at risk' screening. The ultimate success of this study will be in the implementation of UNHS across New Zealand.