Economic analysis of outreach assessment clinics in breast screening programmes

A model is developed for the economic evaluation of outreach assessment cli nics following screening and used to identify the cost-minimizing strategy for assessing women from three island communities in the Scottish Breast Sc reening Programme (SBSP). There are four options of interest depending on: whether the women are assessed on the mainland or at outreach assessment cl inics; and whether all women have two view screening rather than only those being screened for the first time. The benefits of outreach assessment are assumed to be solely in terms of convenience to women and reductions in th e time and travel costs of women recalled for assessment. The costs are mod elled in order to compare outreach and no outreach options. The results sho w that for the numbers of women currently screened outreach assessment is t he cost-minimizing strategy. The model provides useful guidance with respec t to screening policy and is readily applied to the case of outreach assess ment in mainland communities outwith major population centres and to breast and other screening programmes in other countries. Copyright (C) 1999 John Wiley & Sons, Ltd.