Owens D K, Nease R F, Harris R A
Veterans Affairs Palo Alto Health Care System, Calif, USA.
Arch Intern Med. 1996 Feb 26;156(4):394-404.
Although screening inpatients for human immunodeficiency virus (HIV) in acute care hospital settings has been recommended, the cost-effectiveness of screening is not known.
To estimate the cost-effectiveness of a voluntary screening program in acute care hospitals and associated clinics.
During the first year, an HIV screening program implemented in acute care hospital settings in which the seroprevalence of HIV infection is 1% or more would result in the identification of approximately 110,000 undetected cases of HIV infection. The program would result in expenditures of approximately $171 million for testing and counseling, and expenditures of approximately $2 billion for incremental medical care for the patients identified as having HIV infection during the first year of screening. When the seroprevalence of HIV is 1%, the cost-effectiveness of screening is $47,200 per year of life saved. When the effect of early identification of HIV infection on the patient's quality of life also is considered, screening is less cost-effective. Screening-induced reductions in risk behavior improve the cost-effectiveness of screening by preventing the transmission of HIV.
尽管已建议在急症医院环境中对住院患者进行人类免疫缺陷病毒（HIV）筛查，但筛查的成本效益尚不清楚。
评估急症医院及相关诊所中自愿筛查项目的成本效益。
在第一年，在HIV感染血清流行率为1%或更高的急症医院环境中实施的HIV筛查项目，将导致识别出约110,000例未被发现的HIV感染病例。该项目将导致检测和咨询方面的支出约1.71亿美元，以及在筛查的第一年为被确定感染HIV的患者增加医疗护理方面的支出约20亿美元。当HIV血清流行率为1%时，筛查的成本效益为每挽救一年生命47,200美元。当考虑到早期识别HIV感染对患者生活质量的影响时，筛查的成本效益较低。筛查导致的危险行为减少通过预防HIV传播提高了筛查的成本效益。
