Cost analysis of a novel HIV testing strategy in community pharmacies and retail clinics
Cost analysis of a novel HIV testing strategy in community pharmacies and retail clinics
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DOI：
10.1331/japha.2015.150630
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发表时间：
2015-09-01
影响因子：
2.1
通讯作者：
Weidle, Paul J.
中科院分区：
文献类型：
--
作者：
Lecher, Shirley Lee;Shrestha, Ram K.;Weidle, Paul J.
目的：记录在繁忙的社区药店和零售诊所实施护理点(POC)人类免疫缺陷病毒(HIV)快速检测的成本。在社区药房和零售诊所提供艾滋病毒检测服务是扩大艾滋病毒检测的一种创新方式。在繁忙的零售环境中实施POC HIV快速检测的成本需要记录下来，以便为计划和政策领导人提供足够的规划和预算信息。设计：在社区药店和零售诊所提供机密POC HIV快速检测服务的试点项目的成本分析。背景：在城市和农村地区，药房在几种不同的所有权结构(营利性、非营利、独资、公司、公共和私人)下运营。我们纳入了最初参与该项目的六个网站的数据。我们收集了药房和零售诊所工作人员在测试前和测试后咨询所花费的时间，记录在每次互动的活动日志中。参与者：药剂师和零售诊所工作人员。干预：HIV快速检测。主要观察指标：计算总成本，包括检测试剂盒、控制试剂盒、运输、测试用品、培训、报告、项目管理和广告的成本。结果：6个网站培训了22名工作人员实施HIV检测。在12个月的中位数时间内，总共进行了939次艾滋病毒快速检测，其中17次是反应。测验前咨询时间的中位数为2分钟。对于无反应测试的患者，测试后咨询时间的中位数为2分钟，而对于反应测试的患者，中位测试后咨询时间为10分钟。每个被测试的人的平均成本估计为47.21美元。当我们只考虑经常性成本时，每人检测的平均成本为32.17美元。结论：提供POC HIV快速检测服务需要适度的工作人员时间和成本，与在这些环境中提供的其他服务相当。在药房和零售诊所进行艾滋病毒检测可以为增加美国艾滋病毒检测服务的可得性和可及性提供另一个替代场所。
Objective: To document the cost of implementing point-of-care (POC) human immunodeficiency virus (HIV) rapid testing in busy community pharmacies and retail clinics. Providing HIV testing services in community pharmacies and retail clinics is an innovative way to expand HIV testing. The cost of implementing POC HIV rapid testing in a busy retail environment needs to be documented to provide program and policy leaders with adequate information for planning and budgeting.Design: Cost analysis from a pilot project that provided confidential POC HIV rapid testing services in community pharmacies and retail clinics.Setting: The pharmacy sites were operated under several different ownership structures (for-profit, nonprofit, sole proprietorship, corporation, public, and private) in urban and rural areas. We included data from the initial six sites that participated in the project. We collected the time spent by pharmacy and retail clinic staff for pretest and posttest counseling in an activity log for time-in-motion for each interaction.Participants: Pharmacists and retail clinic staff.Intervention: HIV rapid testing.Main outcome measures: The total cost was calculated to include costs of test kits, control kits, shipping, test supplies, training, reporting, program administration, and advertising.Results: The six sites trained 22 staff to implement HIV testing. A total of 939 HIV rapid tests were conducted over a median time of 12 months, of which 17 were reactive. Median pretest counseling time was 2 minutes. Median posttest counseling time was 2 minutes for clients with a nonreactive test and 10 minutes for clients with a reactive test. The average cost per person tested was an estimated $47.21. When we considered only recurrent costs, the average cost per person tested was $32.17.Conclusions: Providing POC HIV rapid testing services required a modest amount of staff time and costs that are comparable to other services offered in these settings. HIV testing in pharmacies and retail clinics can provide an additional alternative venue for increasing the availability and accessibility of HIV testing services in the United States.