[Federal Register: February 23, 2007 (Volume 72, Number 36)]
[Notices]
[Page 8165-8166]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23fe07-47]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[30Day-07-0242X]
Agency Forms Undergoing Paperwork Reduction Act Review
The Centers for Disease Control and Prevention (CDC) publishes a
list of information collection requests under review by the Office of
Management and Budget (OMB) in compliance with the Paperwork Reduction
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call
the CDC Reports Clearance Officer at (404) 639-5960 or send an e-mail
to omb@cdc.gov. Send written comments to CDC Desk Officer, Office of
Management and Budget, Washington, DC or by fax to (202) 395-6974.
Written comments should be received within 30 days of this notice.
Proposed Project
Estimating the Cost of Sigmoidoscopy and Colonoscopy for Colorectal
Cancer Screening in U.S. Healthcare Facilities (SECOST) --New--National
Center for Chronic Disease and Public Health Promotion (NCDDPHP),
Centers for Disease Control and Prevention (CDC).
Background and Brief Description
Colorectal cancer (CRC) is the second leading cause of cancer-
related deaths in the United States. In 2005, it was estimated that
approximately 56,300 Americans died from CRC and about 145,300 new
cases were diagnosed. The risk of developing CRC increases with
advancing age. More than 90% of newly diagnosed CRCs occur in persons
50 years of age and older. Several scientific studies have demonstrated
that regular screening for CRC reduces the incidence and mortality from
this disease. Other studies have shown that regular screening for CRC
is also cost-effective in terms of years of life saved.
Despite strong scientific evidence and evidence-based clinical
guidelines recommending screening, current screening rates remain low.
A recent CDC study reported that more than 40 million Americans who are
50 years of age or older and at average risk for CRC have not been
screened in accordance with current guidelines. The study also reported
that screening this population with current endoscopic (i.e., flexible
sigmoidoscopy and colonoscopy) capacity in the health care system could
require as much as ten years to complete. An effective national effort
to promote CRC screening could increase the demand for endoscopic
procedures.
It has been reported that reimbursements for endoscopic procedures
in publicly-funded programs may not be adequate to cover the costs of
performing these procedures. This may be a disincentive for providers
to perform endoscopy procedures. Currently, there is little information
available about the resources required or the cost of providing these
procedures in different types of healthcare facilities in the United
States.
The purpose of this project is to conduct a survey of a nationally
representative sample of healthcare facilities in order to estimate the
average variable costs of providing colonoscopy and flexible
sigmoidoscopy for CRC screening and follow-up services. Over time,
payments need to cover fixed costs in addition to variable costs. If
some facilities have the ability to provide more procedures without
additional investment in space or equipment, then recovering fixed
costs is not necessary at least in the short run. The estimated average
variable cost by procedure will be compared to the reimbursement rates
for both screening procedures in order to determine whether the
payments to facilities exceed this minimum threshold. Otherwise,
facilities will find reimbursement a potential barrier to expansion of
CRC screening to
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uninsured or underinsured populations even if there is underutilized
capacity. The study will also determine whether there are factors that
affect average variable costs across facilities such as the number of
procedures performed, specialization in types of procedures or other
characteristics of the facility. Results of this study will be used to
better understand the economics of colorectal cancer screening.
Respondents include medical facility receptionists, hospital
operators, and office/business managers. The total estimated cost to
respondents is approximately $72,800 assuming an hourly wage of $37 for
office/business managers and an hourly wage of $11 for others during
the study period. There are no costs to the respondents other than
their time. The total estimated annualized burden hours are 2072.
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\1\ We expect that we will have to make 4,160 screening
telephone calls to identify a sample of 1,250 HOPDs and 906 ASCs
that are eligible for inclusion in the study.
Estimated Annualized Burden Hours
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Number of Average
Number of responses burden per
Type of respondent Form name respondents per response
respondent (in hours)
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Receptionist.............................. Telephone screening survey... \1\ 4,160 1 5/60
OPHD nurse manager........................ SECOST mail survey........... 1,000 1 1
ASC nurse manager......................... SECOST mail survey........... 725 1 1
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Dated: February 16, 2007.
Joan F. Karr,
Acting Reports Clearance Officer, Centers for Disease Control and
Prevention.
[FR Doc. E7-3099 Filed 2-22-07; 8:45 am]
BILLING CODE 4163-18-P