Document 0454
 DOCN  M9460454
 TI    Cost-effectiveness analysis of screening health care workers for HIV.
 DT    9404
 AU    Chavey WE; Cantor SB; Clover RD; Reinarz JA; Spann SJ; Department of
       Family Medicine, University of Texas Medical Branch; at Galveston
       77555-0853.
 SO    J Fam Pract. 1994 Mar;38(3):249-57. Unique Identifier : AIDSLINE
       MED/94172272
 AB    BACKGROUND. Because of the public's concern regarding the possibility of
       human immunodeficiency virus (HIV) transmission from health care worker
       to patient, this study evaluated the cost-effectiveness of screening
       health care workers for HIV. METHODS. The study examined a screening
       protocol that would include a sequence of antibody tests (enzyme-linked
       immunosorbent assay and the Western blot) and culture for HIV. The
       incremental cost-effectiveness of applying this protocol as opposed to
       the status quo for the prevention of transmission of HIV from health
       care worker to patient was evaluated. Sensitivity analysis was performed
       on appropriate variables. The incremental cost-effectiveness ratio was
       then compared with that of other interventions. RESULTS. The expected
       annual cost of screening to a large hospital was found to be $244,382 to
       prevent 0.02663 transmissions. The incremental cost-effectiveness ratio
       was $9,177,615 per transmission prevented. Sensitivity analysis revealed
       that the incremental cost-effectiveness ratio is relatively insensitive
       to the variability in the performance characteristics of the individual
       tests but highly sensitive to variance in HIV prevalence, estimated risk
       of transmission, and the number of exposure-prone procedures performed
       annually. Cost-effectiveness ratios ranged from $917,762 to $91,776,156
       per transmission prevented. CONCLUSIONS. Screening health care workers
       for prevention of potential HIV transmission to patients is an expensive
       use of health care resources.
 DE    AIDS Serodiagnosis/*ECONOMICS  Comparative Study  Cost-Benefit Analysis
       Disease Transmission, Professional-to-Patient/ECONOMICS/  PREVENTION &
       CONTROL  Hospital Bed Capacity, 500 and over  Hospital Costs  Hospitals,
       University/ECONOMICS/MANPOWER  Human  HIV Infections/*PREVENTION &
       CONTROL/TRANSMISSION  Mass Screening/*ECONOMICS  Models, Theoretical
       *Personnel, Hospital/ECONOMICS  Risk  United States  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).