Perspectives in cervical cancer prevention and health services management

Preventive screening, management, and treatment of patients at risk for cervical cancer reduces the incidence of cervical cancer in the United States but not without significant costs. The costs can be measured both in dollars and in "opportunity costs" (access to care for one patient affecting another patient visit) associated with providing care to an overburdened colposcopy infrastructure. To provide colposcopic services, sometimes access to other needed care may be neglected in clinical practices that are already overburdened by high demand and limited access to care. Colposcopy services in the fee-for-service, managed-care, health maintenance organizations, and academic health service delivery settings are delivered not solely on the basis of quality (expertise and technological advances) of care. Delivery of colposcopy services should be balanced by economic and service-related issues as well. This study aids clinicians in assessing the value of interventions based on the value equation for health care: quality, service, and cost impact.