The cost-effectiveness of voluntary intrapartum rapid human immunodeficiency virus testing for women without adequate prenatal care

Citation
Wa. Grobman et Pm. Garcia, The cost-effectiveness of voluntary intrapartum rapid human immunodeficiency virus testing for women without adequate prenatal care, AM J OBST G, 181(5), 1999, pp. 1062-1071
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
0002-9378 → ACNP
Volume
181
Issue
5
Year of publication
1999
Part
1
Pages
1062 - 1071
Database
ISI
SICI code
0002-9378(199911)181:5<1062:TCOVIR>2.0.ZU;2-2
Abstract
OBJECTIVES: We sought to determine the health and economic consequences of voluntary rapid human immunodeficiency testing during labor for women who h ave not received adequate prenatal care. STUDY DESIGN: A decision-tree model was used to assess the number of pediat ric human immunodeficiency virus cases that would be averted if women who w ere unable to determine their human immunodeficiency virus serostatus anten atally were offered an intrapartum rapid human immunodeficiency virus test. Medical costs associated with the introduction of this policy were also de termined. Probability and cost estimates entered into the model are based o n data in the published literature. RESULTS: Under the base-case assumptions, a policy of intrapartum voluntary rapid human immunodeficiency virus testing decreases the number of cases o f perinatal human immunodeficiency virus from 407 to 339 per 100,000 women without adequate prenatal care per year, with a corresponding cost savings of $6 million. Sensitivity analysis demonstrates that these cost savings ar e maintained across a wide range of assumptions and that even conservative scenarios still result in a cost-effective policy. CONCLUSIONS: In the absence of adequate prenatal care, a voluntary rapid hu man immunodeficiency virus test not only allows patients to fully explore t heir options with regard to testing and treatment but also has the potentia l to provide significant health benefits to women and children and economic benefits to the medical system.