Private Costs Associated with Abdominal Aortic Aneurysm Screening: The Importance of Private Travel and Time Costs

Abstract

Objectives — To assess the importance of the private costs incurred by patients when making a judgment on the economics of screening for abdominal aortic aneurysm (AAA), and to explore the variation in such costs depending on screening location. Setting — A district general hospital and general practitioner surgeries. Methods — Four hundred and ninety nine consecutive subjects attending for AAA screening completed a questionnaire asking about travel arrangements for the journey to and from the clinic, the distance travelled, the time taken, the mode of transport, and any out-of-pocket expenses incurred. In addition, at the clinic each subject was asked what activities they had forgone in attending the clinic. Time was valued differently depending on whether work or leisure activities were forgone. The total private cost for each attender was calculated and comparison was made between attenders at hospital and at general practice. Results — A significantly greater proportion of subjects were accompanied when attending hospital than when attending general practitioner (GP) surgeries. Most attenders travelled by car, but the journey time was significantly longer for those visiting hospital. The expected total private cost associated with attendance for AAA screening was £5.47. Attendance at GP surgeries had a lower private cost (£4.21) than attendance at hospital (£6.87). Only 7·3% of all men surveyed, and 6·5% of all companions, would have been taking part in some form of paid occupation if they had not attended for screening. Conclusion — Despite the fact that most attenders for AAA screening will be retired, the associated private costs are appreciable and should be considered in assessing the economics of such screening programmes. The level of private costs varied depending on the location of screening: clinics held at GP practices had lower private costs than those held at hospital.