Cost-effectiveness analysis of human papillomavirus DNA testing and Pap smear for cervical cancer screening in a publicly financed health-care system.

OBJECTIVE: to evaluate the long-term cost-effectiveness of different strategies for human papillomavirus (HPV) DNA testing combined with Pap smear for cervical cancer screening in Taiwan. METHODS: this study adopts a perspective of Department of Health in cost-effectiveness analysis to compare a no-screening strategy with nine different screening strategies. These strategies comprise three screening tools (Pap smear alone, HPV DNA testing followed by Pap smear triage, and HPV DNA testing combined with Pap smear), and three screening intervals (annually, every 3 years, and every 5 years). Outcomes are life expectancy, quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analyses (PSAs) were conducted to assess parameter uncertainty. RESULTS: when three times gross domestic product per capita is used as the decision threshold, all nine screening strategies were cost-effective compared with the no-screening strategy. Compared with the current screening strategy (an annual Pap smear), HPV DNA testing followed by Pap smear triage every 5 years and every 3 years were cost-effective. Results of PSA also indicated that a HPV DNA testing followed by Pap smear triage every 5 or every 3 years achieved the highest expected net benefits. CONCLUSIONS: possible economic advantages are associated with extending the cervical cancer screening interval from one Pap smear annually to HPV DNA testing followed by Pap smear triage every 5 years with an ICER $1 247 000 per QALY gained, especially in a country with a publicly financed health-care system.

Organizational attractiveness of firms in the People's Republic of China: a person-organization fit perspective.

The authors investigated factors related to firm attractiveness as an employer in the People's Republic of China. The organizational attributes of type of ownership, nationality of the supervisor, and firm familiarity in organizational descriptions were manipulated and their effects were measured on firm attractiveness. In addition, the authors adopted a person-organization fit perspective to investigate how individual difference characteristics moderated the effects of these organizational attributes on attractiveness. Although, in general, participants were more attracted to foreign than state-owned firms and to familiar than unfamiliar firms, results provided support for the person-organization fit perspective in that the individual differences moderated the effects of the organizational attributes on firm attractiveness. For example, participants were more attracted to state-owned versus foreign firms when they were more risk averse and had a lower need for pay. Thus, the results provide initial support for the generalizability of the person-organization fit perspective to a non-Western setting.