RATIONALE: Rates of colorectal cancer (CRC) are on the rise in Canada. Flexible sigmoidoscopy (FS) is an initial screening test for CRC primarily used in adults aged 50 years and older at average risk for the disease. Physicians and registered nurses have been shown to have the same effectiveness in performing a FS procedure. This paper presents an analysis of the use of registered nurses (RN) compared to physicians in Ontario to assess costs to the healthcare system. OBJECTIVES: To evaluate whether FS performed by RNs is a less costly alternative to increase access to CRC screening capacity in Ontario. METHODOLOGY: A cost minimization analysis was conducted from a health system perspective. DISCUSSION: RN-performed FS is a viable alternative for increasing CRC screening capacity in Ontario. Remuneration schedules for on-call physicians must be taken into consideration if policies are developed for the implementation of RN screening procedures. RESULTS: The findings suggest that the use of RNs may be cost saving compared to physician-performed FS procedures, depending on physician remuneration.
RATIONALE: Rates of colorectal cancer (CRC) are on the rise in Canada. Flexible sigmoidoscopy (FS) is an initial screening test for CRC primarily used in adults aged 50 years and older at average risk for the disease. Physicians and registered nurses have been shown to have the same effectiveness in performing a FS procedure. This paper presents an analysis of the use of registered nurses (RN) compared to physicians in Ontario to assess costs to the healthcare system. OBJECTIVES: To evaluate whether FS performed by RNs is a less costly alternative to increase access to CRC screening capacity in Ontario. METHODOLOGY: A cost minimization analysis was conducted from a health system perspective. DISCUSSION: RN-performed FS is a viable alternative for increasing CRC screening capacity in Ontario. Remuneration schedules for on-call physicians must be taken into consideration if policies are developed for the implementation of RN screening procedures. RESULTS: The findings suggest that the use of RNs may be cost saving compared to physician-performed FS procedures, depending on physician remuneration.
Authors: P Schoenfeld; S Lipscomb; J Crook; J Dominguez; J Butler; L Holmes; D Cruess; D Rex Journal: Gastroenterology Date: 1999-08 Impact factor: 22.682