A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening

Dubno, Judy R.; Majumder, Pranab; Bettger, Janet Prvu; Dolor, Rowena J.; Eifert, Victoria; Francis, Howard W.; Pieper, Carl F.; Schulz, Kristine A.; Silberberg, Mina; Smith, Sherri L.; Walker, Amy R.; Witsell, David L.; Tucci, Debara L.

doi:10.1186/s12962-022-00360-5

Cost Effectiveness and Resource Allocation

Table 5 Cost calculations for patients in each group

From: A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening

Description	Formula	Home-NPE	Home-PE	Clinic-PE
Intake costs	$\frac{{T}_{F}}{60}.{C}_{F}$	$0.67	$0.67	$0.67
Nurse costs	$\frac{{T}_{N}}{60}.{C}_{N}$	$1.67	$1.67	$1.67
PCP costs	$\frac{{T}_{D}}{60}.{C}_{D}$	$7.50	$12.50	$12.50
Printed material cost	${C}_{Print}$	$0.05	$0.05	$0.05
HS cost	${C}_{Screen}$	$8.00	$8.00	$8.00
HS room cost	$\frac{{T}_{Screen}}{60}.{C}_{Room}$	–	–	$8.33
Total intake cost	$\left(\frac{{T}_{F}}{60}.{C}_{F}\right).{N}_{1Scr}$	$187.33	$258.67	$190.67
Total nurse cost and printed material cost	$\left(\frac{{T}_{N}}{60}.{C}_{N}+{C}_{Print}\right). {N}_{2Elig}$	$405.13	$506.42	$427.45
Total PCP cost	$\left(\frac{{T}_{D}}{60}.{C}_{D}\right). {N}_{3Enr}$	$1650.00	$2750.00	$2750.00
Total HS and screening room (if applicable) cost	$\left({C}_{Screen}+\frac{{T}_{Screen}}{60}.{C}_{Room}\right).{N}_{4HS}$	$400.00	$472.00	$3593.33
Total follow-up cost	${C}_{FollowUp}.{N}_{6Fol}$	$10,128.00	$8,862.00	$24,898.00
Total hearing aid cost	${C}_{HA}.{N}_{8GotHA}$	$4600.00	$0.00	$18,400.00
Sum of clinic costs (i.e., until HS failure)	${S}_{5Fail}=\left(\frac{{T}_{F}}{60}.{C}_{F}\right).{N}_{1Scr}+\left(\frac{{T}_{N}}{60}.{C}_{N}+{C}_{Print}\right). {N}_{2Elig}+\left(\frac{{T}_{D}}{60}.{C}_{D}\right). {N}_{3Enr}+\left({C}_{Screen}+\frac{{T}_{Screen}}{60}.{C}_{Room}\right).{N}_{4HS}$	$2642.47	$3987.08	$6961.45
Average PCP cost per eligible patient	$\frac{{S}_{5Fail}}{{N}_{2Elig}}$	$11.20	$13.51	$27.96
Average PCP cost per enrolled patient	$\frac{{S}_{5Fail}}{{N}_{3Enr}}$	$12.01	$18.12	$31.64
Average PCP cost per patient who completed HS	$\frac{{S}_{5Fail}}{{N}_{4HS}}$	$52.85	$67.58	$31.64
Average PCP cost per patient who failed HS	$\frac{{S}_{5Fail}}{{N}_{5Fail}}$	$62.92	$73.83	$58.01
Sum of all costs	$S={S}_{5Fail}+{C}_{FollowUp}.{N}_{6Fol}+{C}_{HA}.{N}_{8GotHA}$	$17,370.47	$12,849.08	$50,259.45
Average cost per eligible patient	$\frac{S}{{N}_{2Elig}}$	$73.60	$43.56	$201.85
Average cost per enrolled patient	$\frac{S}{{N}_{3Enr}}$	$78.96	$58.40	$228.45
Average cost per patient who completed HS	$\frac{S}{{N}_{4HS}}$	$347.41	$217.78	$228.45
Average cost per patient who failed HS	$\frac{S}{{N}_{5Fail}}$	$413.58	$237.95	$418.83

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Description	Formula	Home-NPE	Home-PE	Clinic-PE
Intake costs	\(\frac{{T}_{F}}{60}.{C}_{F}\)	$0.67	$0.67	$0.67
Nurse costs	\(\frac{{T}_{N}}{60}.{C}_{N}\)	$1.67	$1.67	$1.67
PCP costs	\(\frac{{T}_{D}}{60}.{C}_{D}\)	$7.50	$12.50	$12.50
Printed material cost	\({C}_{Print}\)	$0.05	$0.05	$0.05
HS cost	\({C}_{Screen}\)	$8.00	$8.00	$8.00
HS room cost	\(\frac{{T}_{Screen}}{60}.{C}_{Room}\)	–	–	$8.33
Total intake cost	\(\left(\frac{{T}_{F}}{60}.{C}_{F}\right).{N}_{1Scr}\)	$187.33	$258.67	$190.67
Total nurse cost and printed material cost	\(\left(\frac{{T}_{N}}{60}.{C}_{N}+{C}_{Print}\right). {N}_{2Elig}\)	$405.13	$506.42	$427.45
Total PCP cost	\(\left(\frac{{T}_{D}}{60}.{C}_{D}\right). {N}_{3Enr}\)	$1650.00	$2750.00	$2750.00
Total HS and screening room (if applicable) cost	\(\left({C}_{Screen}+\frac{{T}_{Screen}}{60}.{C}_{Room}\right).{N}_{4HS}\)	$400.00	$472.00	$3593.33
Total follow-up cost	\({C}_{FollowUp}.{N}_{6Fol}\)	$10,128.00	$8,862.00	$24,898.00
Total hearing aid cost	\({C}_{HA}.{N}_{8GotHA}\)	$4600.00	$0.00	$18,400.00
Sum of clinic costs (i.e., until HS failure)	\({S}_{5Fail}=\left(\frac{{T}_{F}}{60}.{C}_{F}\right).{N}_{1Scr}+\left(\frac{{T}_{N}}{60}.{C}_{N}+{C}_{Print}\right). {N}_{2Elig}+\left(\frac{{T}_{D}}{60}.{C}_{D}\right). {N}_{3Enr}+\left({C}_{Screen}+\frac{{T}_{Screen}}{60}.{C}_{Room}\right).{N}_{4HS}\)	$2642.47	$3987.08	$6961.45
Average PCP cost per eligible patient	\(\frac{{S}_{5Fail}}{{N}_{2Elig}}\)	$11.20	$13.51	$27.96
Average PCP cost per enrolled patient	\(\frac{{S}_{5Fail}}{{N}_{3Enr}}\)	$12.01	$18.12	$31.64
Average PCP cost per patient who completed HS	\(\frac{{S}_{5Fail}}{{N}_{4HS}}\)	$52.85	$67.58	$31.64
Average PCP cost per patient who failed HS	\(\frac{{S}_{5Fail}}{{N}_{5Fail}}\)	$62.92	$73.83	$58.01
Sum of all costs	\(S={S}_{5Fail}+{C}_{FollowUp}.{N}_{6Fol}+{C}_{HA}.{N}_{8GotHA}\)	$17,370.47	$12,849.08	$50,259.45
Average cost per eligible patient	\(\frac{S}{{N}_{2Elig}}\)	$73.60	$43.56	$201.85
Average cost per enrolled patient	\(\frac{S}{{N}_{3Enr}}\)	$78.96	$58.40	$228.45
Average cost per patient who completed HS	\(\frac{S}{{N}_{4HS}}\)	$347.41	$217.78	$228.45
Average cost per patient who failed HS	\(\frac{S}{{N}_{5Fail}}\)	$413.58	$237.95	$418.83