Costs and Consequences of Eliminating a Routine, Point-Of-Care HIV Screening Program in a High-Prevalence Jail
| Autor: | Wendy Wen, Madeline Adee, Angela B. Hutchinson, Robin J. MacGowan, Andrew D. Margolis, Anne C. Spaulding, Chava J. Bowden |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Routine screening Epidemiology business.industry Cost effectiveness Public health Cost-Benefit Analysis Point-of-Care Systems Public Health Environmental and Occupational Health Human immunodeficiency virus (HIV) HIV screening HIV Infections Cost-effectiveness analysis medicine.disease medicine.disease_cause Prevention goals medicine Prevalence Humans Mass Screening Medical emergency business health care economics and organizations Jails Point of care |
| Zdroj: | American journal of preventive medicine. 61(5 Suppl 1) |
| ISSN: | 1873-2607 |
| Popis: | Introduction This study aims to assess the public health impact of eliminating a longstanding routine HIV screening program and replacing it with targeted testing. In addition, costs, outcomes, and cost effectiveness of routine screening are compared with those of targeted testing in the Fulton County Jail, Atlanta, Georgia. Methods A published mathematical model was used to assess the cost effectiveness and public health impact of routine screening (March 2013–February 2014) compared with those of targeted testing (January 2018–December 2018) from a health system perspective. Costs, outcomes, and other model inputs were derived from the testing programs and the published literature, and the cost effectiveness analysis was conducted from 2019 to 2020. Results Routine screening identified 74 more new HIV infections over 1 year than targeted testing, resulting in an estimated 10 HIV transmissions averted and 45 quality-adjusted life-years saved, and was cost saving. The missed opportunity to diagnose infections because routine screening was eliminated resulted in an estimated 8.4 additional HIV transmissions and $3.7 million in additional costs to the healthcare system. Conclusions Routine HIV screening in high-prevalence jails is cost effective and has a larger impact on public health than targeted testing. Prioritizing sustained funding for routine, jail-based HIV screening programs in high-prevalence areas may be important to realizing the national HIV prevention goals. |
| Databáze: | OpenAIRE |
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