Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Public Health Manag Pract. 2012 May-Jun;18(3):259-67. doi: 10.1097/PHH.0b013e31822b2077.
The Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention, spends approximately 50% of its $325 million annual human immunodeficiency virus (HIV) prevention funds for HIV-testing services. An accurate estimate of the costs of HIV testing in various settings is essential for efficient allocation of HIV prevention resources.
To assess the costs of HIV-testing interventions using different costing methods.
DESIGN, SETTINGS, AND PARTICIPANTS: We used the microcosting-direct measurement method to assess the costs of HIV-testing interventions in nonclinical settings, and we compared these results with those from 3 other costing methods: microcosting-staff allocation, where the labor cost was derived from the proportion of each staff person's time allocated to HIV testing interventions; gross costing, where the New York State Medicaid payment for HIV testing was used to estimate program costs, and program budget, where the program cost was assumed to be the total funding provided by Centers for Disease Control and Prevention.
Total program cost, cost per person tested, and cost per person notified of new HIV diagnosis.
The median costs per person notified of a new HIV diagnosis were $12 475, $15 018, $2697, and $20 144 based on microcosting-direct measurement, microcosting-staff allocation, gross costing, and program budget methods, respectively. Compared with the microcosting-direct measurement method, the cost was 78% lower with gross costing, and 20% and 61% higher using the microcosting-staff allocation and program budget methods, respectively.
Our analysis showed that HIV-testing program cost estimates vary widely by costing methods. However, the choice of a particular costing method may depend on the research question being addressed. Although program budget and gross-costing methods may be attractive because of their simplicity, only the microcosting-direct measurement method can identify important determinants of the program costs and provide guidance to improve efficiency.
美国疾病控制与预防中心（CDC）艾滋病毒/艾滋病预防司每年将其 3.25 亿美元艾滋病毒预防资金的大约 50%用于艾滋病毒检测服务。准确估算各种情况下艾滋病毒检测的成本对于有效分配艾滋病毒预防资源至关重要。
使用不同的成本核算方法评估艾滋病毒检测干预措施的成本。
设计、地点和参与者：我们使用微观成本直接测量方法评估非临床环境中艾滋病毒检测干预措施的成本，并将这些结果与其他 3 种成本核算方法进行比较：微观成本-人员分配，其中劳动力成本来自每个工作人员分配给艾滋病毒检测干预措施的时间比例；总费用，其中使用纽约州医疗补助计划对艾滋病毒检测的支付来估计项目成本；项目预算，其中项目成本被假定为疾病预防控制中心提供的总资金。
总项目成本、人均检测成本和人均新艾滋病毒诊断通知成本。
根据微观成本直接测量、微观成本人员分配、总费用和项目预算方法，人均新艾滋病毒诊断通知成本分别为 12475 美元、15018 美元、2697 美元和 20144 美元。与微观成本直接测量方法相比，总费用法的成本低 78%，微观成本人员分配法和项目预算法的成本分别高 20%和 61%。
我们的分析表明，艾滋病毒检测项目成本估算因成本核算方法而异。然而，特定成本核算方法的选择可能取决于所解决的研究问题。虽然程序预算和总费用核算方法可能因其简单性而具有吸引力，但只有微观成本直接测量方法才能确定项目成本的重要决定因素，并提供提高效率的指导。
