Comparing the Costs of HIV Screening Strategies and Technologies in Health-Care Settings
Comparing the Costs of HIV Screening Strategies and Technologies in Health-Care Settings
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DOI：
10.1177/00333549081230s307
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Branson, Bernard M.
中科院分区：
文献类型：
--
作者：
Farnham, Paul G.;Hutchinson, Angela B.;Branson, Bernard M.
目标. 2006年，疾病控制和预防中心（CDC）建议在美国所有医疗机构对13至64岁的人进行常规人类免疫缺陷病毒（HIV）筛查。早期的建议集中在那些高风险的艾滋病毒，并包括更广泛的测试前咨询。艾滋病毒筛查也可能涉及快速或常规检测。本研究的目的是估计这些不同的检测程序的成本和成本每艾滋病毒感染者正确接收检测结果在三个卫生保健方案，说明这些政策的差异。该研究估计了以下情况下快速和常规HIV检测的成本：（1）性传播疾病（STD）诊所咨询和检测（CT），（2）STD诊所筛查，（3）急诊科（艾德）筛查。费用是从供应商的角度以2006年美元估计的。一个决策分析模型被开发来估计每个HIV感染者的成本通知检测结果使用两个测试程序在三个candidos.Results.Results.虽然整个快速检测程序比常规检测昂贵，但在所有情况下，快速检测的每名艾滋病毒感染者接受检测结果的费用都低于常规检测。每名患者获得结果的成本在艾德筛查方案中最低，在STD CT方案中最高。这些费用对检测费用、HIV流行率和常规检测后的返回率的变化很敏感。在一般保健机构进行艾滋病毒筛查在经济上是可行的，特别是快速检测可以降低艾滋病毒感染者获得检测结果的费用。
Objectives. In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine human immunodeficiency virus (HIV) screening for people aged 13 to 64 years in all U.S. health-care settings. Earlier recommendations focused on those at high risk for HIV and included more extensive pretest counseling. HIV screening may also involve either rapid or conventional testing. The purpose of this research was to estimate the costs of these different testing procedures and the cost per HIV-infected patient correctly receiving test results in three health-care scenarios that illustrated these policy differences.Methods. The study estimated the costs of rapid and conventional HIV testing in the following scenarios: (1) sexually transmitted disease (STD) clinic counseling and testing (CT), (2) STD clinic screening, and (3) emergency department (ED) screening. Costs were estimated from the provider perspective in 2006 dollars. A decision analytic model was developed to estimate the cost per HIV-infected patient notified of test results using the two testing procedures in the three scenarios.Results. Although the complete rapid testing procedure was more expensive than conventional testing, the cost per HIV-infected patient receiving test results was lower for the rapid test compared with conventional testing in all scenarios. Per-patient costs of receiving results were lowest in the ED screening scenario and highest in the STD CT scenario. These costs were sensitive to changes in test costs, HIV prevalence, and return rates following conventional tests.Conclusion. HIV screening in general health-care settings is economically feasible, particularly with rapid tests that lower the cost of HIV-infected patients receiving their test results.