Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, 53202, USA.
AIDS Patient Care STDS. 2010 Jul;24(7):409-13. doi: 10.1089/apc.2009.0348.
In 2006, the United States Centers for Disease Control and Prevention (CDC) recommended expanded and routine use of single-session rapid HIV tests in all health care settings to increase the proportion of persons who learn their HIV status. Limited empiric information is available regarding the costs of rapid testing and pre- and posttest counseling in health care settings. We surveyed 45 U.S. hospitals during 2005 through 2006 to assess the costs associated with rapid testing and counseling. Cost analyses were conducted from the provider (hospital) perspective, and results were expressed in year 2006 U.S. dollars. The mean per-test cost of rapid HIV testing and counseling was $48.07 for an HIV-negative test and $64.17 for a preliminary-positive test. Pre- and posttest counseling costs accounted for 38.4% of the total cost of rapid testing for HIV-negative patients. Counseling costs were significantly correlated with overall test costs. Many hospitals contained overall test costs by limiting time spent in pre- and posttest counseling or by using lower-paid personnel for counseling activities or both. Counseling costs constituted a significant proportion of the overall costs of rapid testing and counseling activities at study hospitals. Our data provide useful baseline data before implementation of the CDC's 2006 recommendations. Costs can be reduced by limiting time spent in pre- and posttest counseling or by using lower-paid personnel for counseling activities or both.
2006 年，美国疾病预防控制中心（CDC）建议在所有医疗保健环境中扩大并常规使用单次检测快速 HIV 测试，以增加了解自身 HIV 状况的人数比例。关于医疗保健环境中快速检测和检测前及检测后咨询的成本，仅有有限的经验性信息可用。我们在 2005 年至 2006 年期间对 45 家美国医院进行了调查，以评估与快速检测和咨询相关的成本。成本分析采用提供者（医院）视角进行，结果以 2006 年的美元表示。阴性 HIV 检测的每次检测和初步阳性 HIV 检测的平均检测成本分别为 48.07 美元和 64.17 美元。检测前和检测后的咨询费用占阴性 HIV 患者快速检测总成本的 38.4%。咨询成本与总检测成本显著相关。许多医院通过限制检测前和检测后咨询的时间、或通过使用薪酬较低的人员进行咨询活动、或两者兼用来控制总体检测成本。咨询成本构成研究医院快速检测和咨询活动总成本的重要部分。我们的数据在实施 CDC 2006 年建议之前提供了有用的基准数据。通过限制检测前和检测后咨询的时间、或通过使用薪酬较低的人员进行咨询活动、或两者兼用来降低成本。
