Hospitalized Women's Willingness to Pay for Inpatient Screening Colonoscopy

Opeoluwa Olayinka, Jerome Gnanaraj, Waseem Khaliq, Opeoluwa Olayinka, Jerome Gnanaraj, Waseem Khaliq

Abstract

Background: Despite the proven mortality benefit of screening colonoscopy, ∼27% of hospitalized women are nonadherent with colorectal cancer (CRC) screening guidelines. Colonoscopy is the most frequently used test for CRC screening in the United States. Although CRC is the second most common cause of cancer death in the United States, CRC screening has not been part of usual hospital care.

Objective: This study explores how hospitalized women perceive value of inpatient screening colonoscopy by evaluating the mean amount of money that hospitalized women are willing to contribute toward the cost of a screening colonoscopy during a hospital stay.

Methods: A cross-sectional bedside survey consisting of a contingent valuation questionnaire was used to assess the contribution these women considered to be justified for the convenience of an inpatient screening colonoscopy. The probit regression model was used for the analysis of contingent valuation data to predict mean willingness to pay toward inpatient screening colonoscopy.

Results: Of the 312 enrolled patients, 48% were willing to pay a mean of $171.56 (95% confidence interval [CI] $37.59-$305.54, p = 0.012) in advance toward the cost of an inpatient screening colonoscopy. After adjustment of possible sociodemographic and clinical covariates that could impact willingness to contribute, hospitalized women were willing to pay a mean of $178.41 (95% CI $40.67-$316.16, p = 0.011).

Conclusions: The findings of this study suggest that hospitalized women value the prospect of screening colonoscopy during hospitalization. Offering screening colonoscopy to nonadherent hospitalized women, especially those who are at high risk for developing CRC, may improve adherence among hospitalized women.

This study is registered at www.clinicaltrials.gov (NCT04162925).

Keywords: hospitalized women; inpatient screening colonoscopy; willingness to pay.

Conflict of interest statement

No competing financial interests exist.

© Opeoluwa Olayinka et al., 2022; Published by Mary Ann Liebert, Inc.

Figures

FIG. 1.
FIG. 1.
Proportion of hospitalized women willing to pay for seven amounts for inpatient screening colonoscopy.

References

    1. Siegel RL, Miller KD, Fuchs HE, et al. . Cancer statistics, 2021. CA Cancer J Clin 2021;71(1):7–33; doi: 10.3322/caac.21654
    1. American Cancer Society. Cancer Facts & Figures 2021. American Cancer Society: Atlanta, GA, USA; 2021.
    1. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. . Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement [published correction appears in JAMA 2016;316(5):545] [published correction appears in JAMA 2017;317(21):2239]. JAMA 2016;315(23):2564–2575; doi:10.1001/jama.2016.5989
    1. Lieberman D, Ladabaum U, Cruz-Correa M, et al. . Screening for colorectal cancer and evolving issues for physicians and patients: A review. JAMA 2016;316(20):2135–2145; doi: 10.1001/jama.2016.17418
    1. Siegel RL, Miller KD, Goding Sauer A, et al. . Colorectal cancer statistics, 2020. CA Cancer J Clin 2020;70(3):145–164; doi: 10.3322/caac.21601
    1. Muthukrishnan M, Arnold LD, James AS. Patients' self-reported barriers to colon cancer screening in federally qualified health center settings. Prev Med Rep 2019;15:100896; doi: 10.1016/j.pmedr.2019.100896
    1. Graham H, Kauffman R, Khaliq W. Colorectal cancer screening prevalence, perceived barriers, and preference for screening colonoscopy among hospitalized women. Turkish J Gastroenterol 2022; [Epub ahead of print]; doi: 10.5152/tjg.2022.21567.
    1. Wools A, Dapper EA, de Leeuw JRJ. Colorectal cancer screening participation: A systematic review. Eur J Public Health 2016;26(1):158–168; doi: 10.1093/eurpub/ckv148
    1. Eke R, Tariq T, Li T, et al. . Colorectal cancer screening in hospitalized patients: Results from the Nationwide Inpatient Sample. Eur J Cancer Prev 2019;28(5):413–419; doi: 10.1097/CEJ.0000000000000488
    1. Drummond MF, Sculpher MJ, Torrance GW, et al. . Methods for the Economic Evaluation of Health Care Programmes, 3rd ed. Oxford University Press: Oxford, England; 2005; pp. 211–239.
    1. Bridges JF. Stated preference methods in health care evaluation: An emerging methodological paradigm in health economics. Appl Health Econ Health Policy 2003;2(4):213–224. PMID: .
    1. Lopez-Feldman A. Introduction to contingent valuation using Stata; 2012. Available from: [Last accessed: February 10, 2022].
    1. Gupta S, Sussman DA, Doubeni CA, et al. . Challenges and possible solutions to colorectal cancer screening for the underserved. J Natl Cancer Inst 2014;106(4):dju032; doi: 10.1093/jnci/dju032.
    1. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Gastroenterology 2017;153(1):307–323; doi: 10.1053/j.gastro.2017.05.013.
    1. Honein-AbouHaidar GN, Kastner M, Vuong V, et al. . Systematic review and meta-study synthesis of qualitative studies evaluating facilitators and barriers to participation in colorectal cancer screening. Cancer Epidemiol Biomarkers Prev 2016;25(6):907–917; doi:10.1158/1055-9965.EPI-15-0990
    1. Khaliq W, Visvanathan K, Landis R, et al. . Breast cancer screening preferences among hospitalized women. J Womens Health (Larchmt) 2013;22(7):637–642; doi: 10.1089/jwh.2012.4083.
    1. Nawaz H, Via C, Shahrokni A, et al. . Can the inpatient hospital setting be a golden opportunity to improve colon cancer screening rates in the United States? Health Promot Pract 2014;15(4):506–511; doi: 10.1177/1524839913518559
    1. Medina GG, McQueen A, Greisinger AJ, et al. . What would make getting colorectal cancer screening easier? Perspectives from screeners and nonscreeners. Gastroenterol Res Pract 2012;2012:895807; doi: 10.1155/2012/895807
    1. Khaliq W, Siferd C, Kantsiper ME, et al. . Capturing the rest: inpatient mammography for nonadherent hospitalized women. Am J Prev Med 2021:S0749-3797(21)00285-3; doi: 10.1016/j.amepre.2021.04.026 [Epub ahead of print]
    1. Khaliq W, Harris CM, Landis R, et al. . Hospitalized women's willingness to pay for an inpatient screening mammogram. Ann Fam Med 2014;12(6):556–558; doi: 10.1370/afm.1694
    1. Available from: [Last accessed: February 10, 2022].
    1. Available from: [Last accessed: February 10, 2022].
    1. Patient Protection and Affordable Care Act, P.L. 111–148, § 1001 (establishing § 2713 of the Public Health Service Act) (codified at 42 U.S.C. § 300gg-13 (2006)).

Source: PubMed

3
Sottoscrivi