Section of Infectious Diseases, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Room 543 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0J9, Canada.
Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Can J Public Health. 2023 Apr;114(2):287-294. doi: 10.17269/s41997-022-00682-0. Epub 2022 Sep 6.
The objective of this study is to provide a direct short-term cost-avoidance analysis of expanded three-time prenatal syphilis screening in the context of Manitoba's ongoing outbreak.
A conservative modelling approach increased all financial costs of prenatal screening and minimized the direct costs of congenital syphilis treatment. The cost of syphilis screening was calculated using instrument, reagent and consumable costs as well as laboratory overhead and labour costs as documented by Cadham Provincial Laboratory. The short-term direct costs of treating congenital syphilis were calculated using hospital costs and doctor's billing fees. All costs were calculated in 2021 Canadian dollars. These numbers were applied to Manitoba's 2021 congenital syphilis statistics to provide a pragmatic cost-avoidance analysis.
The cost of applying three-time prenatal syphilis screening to all 16,800 yearly pregnancies in Manitoba equalled CAD $139,608.00 per year. The direct short-term cost of treating one uncomplicated case of congenital syphilis was $18,151.40. As 81 cases of congenital syphilis were treated in Manitoba in 2021, the short-term direct cost of treating congenital syphilis in Manitoba in 2021 was $1,470,263.40. Applying screening costs to the 125 adequately prevented cases of congenital syphilis in 2021, the screening program is associated with a cost-avoidance ratio of 16.25. If no prenatal syphilis program existed in Manitoba, an expanded screening program would be associated with a cost-avoidance ratio of 26.8.
Expanding prenatal syphilis screening is highly cost-avoidant in Manitoba. The 81 cases of congenital syphilis treated in Manitoba in 2021 highlight the need for novel community-based approaches to increase accessibility and engagement with prenatal care.
本研究旨在针对曼尼托巴省正在发生的梅毒疫情，提供扩大三次产前梅毒筛查的直接短期成本避免分析。
采用保守建模方法增加了所有产前筛查的财务成本，并将先天性梅毒治疗的直接成本降至最低。梅毒筛查的费用是根据 Cadham 省级实验室记录的仪器、试剂和消耗品成本以及实验室间接费用和劳动力成本计算的。先天性梅毒治疗的短期直接费用是根据医院费用和医生的计费费用计算的。所有成本均按 2021 年加拿大元计算。这些数字应用于曼尼托巴省 2021 年先天性梅毒统计数据，提供了一种实用的成本避免分析。
在曼尼托巴省，将三次产前梅毒筛查应用于每年 16800 次妊娠，每年的费用为 139608.00 加元。治疗一例单纯先天性梅毒的直接短期费用为 18151.40 加元。2021 年，曼尼托巴省治疗了 81 例先天性梅毒病例，因此，2021 年曼尼托巴省治疗先天性梅毒的直接短期费用为 1470263.40 加元。将筛查费用应用于 2021 年 125 例充分预防的先天性梅毒病例，该筛查计划的成本避免率为 16.25。如果曼尼托巴省没有产前梅毒计划，扩大的筛查计划将与 26.8 的成本避免率相关。
在曼尼托巴省，扩大产前梅毒筛查具有高度的成本避免性。2021 年，曼尼托巴省治疗的 81 例先天性梅毒病例突显了需要采用新的基于社区的方法，以提高产前保健的可及性和参与度。
