Robinson Suzanne, Roberts Tracy, Barton Pelham, Bryan Stirling, Macleod John, McCarthy Anne, Egger Matthias, Sanford Emma, Low Nicola
Health Economics Facility, Health Services Management Centre, University of Birmingham, 40 Edgbaston Park Road, Birmingham, UK.
Sex Transm Infect. 2007 Jul;83(4):276-81. doi: 10.1136/sti.2006.023374. Epub 2007 Jan 17.
Most economic evaluations of chlamydia screening do not include costs incurred by patients. The objective of this study was to estimate both the health service and private costs of patients who participated in proactive chlamydia screening, using mailed home-collected specimens as part of the Chlamydia Screening Studies project.
Data were collected on the administrative costs of the screening study, laboratory time and motion studies and patient-cost questionnaire surveys were conducted. The cost for each screening invitation and for each accepted offer was estimated. One-way sensitivity analysis was conducted to explore the effects of variations in patient costs and the number of patients accepting the screening offer.
The time and costs of processing urine specimens and vulvo-vaginal swabs from women using two nucleic acid amplification tests were similar. The total cost per screening invitation was 20.37 pounds (95% CI 18.94 pounds to 24.83). This included the National Health Service cost per individual screening invitation 13.55 pounds (95% CI 13.15 pounds to 14.33) and average patient costs of 6.82 pounds (95% CI 5.48 pounds to 10.22). Administrative costs accounted for 50% of the overall cost.
The cost of proactive chlamydia screening is comparable to those of opportunistic screening. Results from this study, which is the first to collect private patient costs associated with a chlamydia screening programme, could be used to inform future policy recommendations and provide unique primary cost data for economic evaluations.
大多数衣原体筛查的经济评估未纳入患者所产生的费用。本研究的目的是估算参与主动衣原体筛查患者的医疗服务成本和私人成本，该筛查采用邮寄家庭采集标本的方式，作为衣原体筛查研究项目的一部分。
收集了筛查研究的管理成本数据，进行了实验室时间与动作研究，并开展了患者成本问卷调查。估算了每次筛查邀请和每次接受筛查邀请的成本。进行了单向敏感性分析，以探讨患者成本变化和接受筛查邀请的患者数量的影响。
使用两种核酸扩增检测方法处理女性尿液标本和外阴 - 阴道拭子的时间和成本相似。每次筛查邀请的总成本为20.37英镑（95%置信区间为18.94英镑至24.83英镑）。这包括国民医疗服务体系每次个体筛查邀请的成本13.55英镑（95%置信区间为13.15英镑至14.33英镑）以及患者平均成本6.82英镑（95%置信区间为5.48英镑至10.22英镑）。管理成本占总成本的50%。
主动衣原体筛查的成本与机会性筛查的成本相当。本研究首次收集了与衣原体筛查项目相关的患者私人成本，研究结果可用于为未来的政策建议提供参考，并为经济评估提供独特的原始成本数据。
