産業医学および健康問題

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Comparative Cost Study of Clinical HIV Testing Prompts at the Veterans Affairs Healthcare System

Joe Henry, Joe Henry

To calculate the costs and health effects of a novel HIV testing approach that makes use of routine-based clinician reminders.

Methods: The standard pretest/posttest counselling, counselling and a new clinical reminders system, and the sole clinical reminder in the veterans' health care system were all the subject of our economic research. The costeffectiveness of three HIV testing strategies over a one-year budget was determined using a payer-perspective decision model. Values for the parameters, such as the likelihood that patients will accept the test and the price of the HIV testing procedures, were taken from the literature.

From August 2004 through December 2011, anonymous patient information was gathered from one clinic in Los Angeles, California, including the total population screened and the number of new HIV diagnoses. Expenditures per new case as well as the year total costs were calculated a foundation for parameter values and patient information. Sensitivity analysis was carried out to determine the critical variable's cost-related robustness.

Results: Compared to $109,208 for conventional HIV testing, the total cost of the clinical reminder system with pretest counselling was $81,726 over a year. The number of HIV tests conducted and the number of new diagnoses rose for that year under a clinical reminder system without pretest counselling. Additionally, the lowest cost per new diagnosis was seen.

Conclusions: When compared to standard HIV testing, the clinical reminder system can lower the cost per case found and improve the efficacy of HIV testing. When implementing a similar programme at a facility outside of Veteran Affairs, the foundational decision model might be employed.