Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial
Background The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results. Objective To examine the costs and benefits of strat...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2010-06, Vol.25 (6), p.556-563 |
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| creator | Sanders, Gillian D. Anaya, Henry D. Asch, Steven Hoang, Tuyen Golden, Joya F. Bayoumi, Ahmed M. Owens, Douglas K. |
| description | Background
The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results.
Objective
To examine the costs and benefits of strategies to improve HIV testing and receipt of results.
Design
Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.
Setting/target population
Primary-care patients with unknown HIV status.
Interventions
Comparison of three intervention models for HIV counseling and testing: Model A = traditional HIV counseling and testing; Model B = nurse-initiated routine screening with traditional HIV testing and counseling; Model C = nurse-initiated routine screening with rapid HIV testing and streamlined counseling.
Main measures
Life-years, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness.
Key results
Without consideration of the benefit from reduced HIV transmission, Model A resulted in per-patient lifetime discounted costs of $48,650 and benefits of 16.271 QALYs. Model B increased lifetime costs by $53 and benefits by 0.0013 QALYs (corresponding to 0.48 quality-adjusted life days). Model C cost $66 more than Model A with an increase of 0.0018 QALYs (0.66 quality-adjusted life days) and an incremental cost-effectiveness of $36,390/QALY. When we included the benefit from reduced HIV transmission, Model C cost $10,660/QALY relative to Model A. The cost-effectiveness of Model C was robust in sensitivity analyses.
Conclusions
In a primary-care population, nurse-initiated routine screening with rapid HIV testing and streamlined counseling increased rates of testing and receipt of test results and was cost-effective compared with traditional HIV testing strategies. |
| doi_str_mv | 10.1007/s11606-010-1265-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2869414</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733315675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c498t-867756b97e7a3a454a1212749a275dfd34b1fdfed9e8fa40042c352e0c006ee3</originalsourceid><addsrcrecordid>eNp1kd-LEzEQxxdRvHr6B_giQZB7Ws3PTdYH4SjVKxwItfga0uxszZEmNdktnI_-5Ze19U4Fn5LMfOY7k_lW1UuC3xKM5btMSIObGhNcE9qIWjyqZkRQURPeysfVDCvFayUZP6ue5XyDMWGUqqfVGcUUc8HUrPo5j3moF30PdnAHCJAzij36MiQzwNZBRkNEy90-xQOgq-VXtIY8uLBFJnRoBRbcfpgKVpBHP-T3aGFjiDtn0WUw_ja7X3IGrQpfwj-gQ_MYhhS9L9d1csY_r570xmd4cTrPq_XHxXp-VV9__rScX17XlrdqqFUjpWg2rQRpmOGCG0IJlbw1VIqu7xjfkL7roWtB9YZjzKllggK2GDcA7Lz6cJTdj5sddBbKFMbrfXI7k251NE7_nQnum97Gg6aqaTnhReDiJJDi97GsQe9ctuC9CRDHrCVjjIhGikK-_oe8iWMq-8haSUIL08gCkSNkU8w5QX8_CsF6slcf7dV4ehd79ST86s8_3Ff89rMAb06Aydb4PplgXX7gaKvalk3N6ZHLJRW2kB4m_H_3O2L-vnE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>871256767</pqid></control><display><type>article</type><title>Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sanders, Gillian D. ; Anaya, Henry D. ; Asch, Steven ; Hoang, Tuyen ; Golden, Joya F. ; Bayoumi, Ahmed M. ; Owens, Douglas K.</creator><creatorcontrib>Sanders, Gillian D. ; Anaya, Henry D. ; Asch, Steven ; Hoang, Tuyen ; Golden, Joya F. ; Bayoumi, Ahmed M. ; Owens, Douglas K.</creatorcontrib><description>Background
The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results.
Objective
To examine the costs and benefits of strategies to improve HIV testing and receipt of results.
Design
Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.
Setting/target population
Primary-care patients with unknown HIV status.
Interventions
Comparison of three intervention models for HIV counseling and testing: Model A = traditional HIV counseling and testing; Model B = nurse-initiated routine screening with traditional HIV testing and counseling; Model C = nurse-initiated routine screening with rapid HIV testing and streamlined counseling.
Main measures
Life-years, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness.
Key results
Without consideration of the benefit from reduced HIV transmission, Model A resulted in per-patient lifetime discounted costs of $48,650 and benefits of 16.271 QALYs. Model B increased lifetime costs by $53 and benefits by 0.0013 QALYs (corresponding to 0.48 quality-adjusted life days). Model C cost $66 more than Model A with an increase of 0.0018 QALYs (0.66 quality-adjusted life days) and an incremental cost-effectiveness of $36,390/QALY. When we included the benefit from reduced HIV transmission, Model C cost $10,660/QALY relative to Model A. The cost-effectiveness of Model C was robust in sensitivity analyses.
Conclusions
In a primary-care population, nurse-initiated routine screening with rapid HIV testing and streamlined counseling increased rates of testing and receipt of test results and was cost-effective compared with traditional HIV testing strategies.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-010-1265-5</identifier><identifier>PMID: 20204538</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Antiretroviral drugs ; Biological and medical sciences ; Cost control ; Cost-Benefit Analysis ; Economic analysis ; General aspects ; HIV ; HIV Infections - diagnosis ; HIV Infections - economics ; HIV Infections - therapy ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Internal Medicine ; Male ; Markov Chains ; Mass Screening - economics ; Medical sciences ; Medical screening ; Medical tests ; Medicine ; Medicine & Public Health ; Middle Aged ; Nursing ; Original ; Original Article ; Patient Acceptance of Health Care ; Patient Compliance ; Prevention and actions ; Primary care ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Sensitivity analysis ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>Journal of general internal medicine : JGIM, 2010-06, Vol.25 (6), p.556-563</ispartof><rights>The Author(s) 2010</rights><rights>2015 INIST-CNRS</rights><rights>Society of General Internal Medicine 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-867756b97e7a3a454a1212749a275dfd34b1fdfed9e8fa40042c352e0c006ee3</citedby><cites>FETCH-LOGICAL-c498t-867756b97e7a3a454a1212749a275dfd34b1fdfed9e8fa40042c352e0c006ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869414/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869414/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,883,27907,27908,41471,42540,51302,53774,53776</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22989937$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20204538$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanders, Gillian D.</creatorcontrib><creatorcontrib>Anaya, Henry D.</creatorcontrib><creatorcontrib>Asch, Steven</creatorcontrib><creatorcontrib>Hoang, Tuyen</creatorcontrib><creatorcontrib>Golden, Joya F.</creatorcontrib><creatorcontrib>Bayoumi, Ahmed M.</creatorcontrib><creatorcontrib>Owens, Douglas K.</creatorcontrib><title>Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Background
The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results.
Objective
To examine the costs and benefits of strategies to improve HIV testing and receipt of results.
Design
Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.
Setting/target population
Primary-care patients with unknown HIV status.
Interventions
Comparison of three intervention models for HIV counseling and testing: Model A = traditional HIV counseling and testing; Model B = nurse-initiated routine screening with traditional HIV testing and counseling; Model C = nurse-initiated routine screening with rapid HIV testing and streamlined counseling.
Main measures
Life-years, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness.
Key results
Without consideration of the benefit from reduced HIV transmission, Model A resulted in per-patient lifetime discounted costs of $48,650 and benefits of 16.271 QALYs. Model B increased lifetime costs by $53 and benefits by 0.0013 QALYs (corresponding to 0.48 quality-adjusted life days). Model C cost $66 more than Model A with an increase of 0.0018 QALYs (0.66 quality-adjusted life days) and an incremental cost-effectiveness of $36,390/QALY. When we included the benefit from reduced HIV transmission, Model C cost $10,660/QALY relative to Model A. The cost-effectiveness of Model C was robust in sensitivity analyses.
Conclusions
In a primary-care population, nurse-initiated routine screening with rapid HIV testing and streamlined counseling increased rates of testing and receipt of test results and was cost-effective compared with traditional HIV testing strategies.</description><subject>Adult</subject><subject>Antiretroviral drugs</subject><subject>Biological and medical sciences</subject><subject>Cost control</subject><subject>Cost-Benefit Analysis</subject><subject>Economic analysis</subject><subject>General aspects</subject><subject>HIV</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - economics</subject><subject>HIV Infections - therapy</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Markov Chains</subject><subject>Mass Screening - economics</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Medical tests</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>Original</subject><subject>Original Article</subject><subject>Patient Acceptance of Health Care</subject><subject>Patient Compliance</subject><subject>Prevention and actions</subject><subject>Primary care</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Sensitivity analysis</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kd-LEzEQxxdRvHr6B_giQZB7Ws3PTdYH4SjVKxwItfga0uxszZEmNdktnI_-5Ze19U4Fn5LMfOY7k_lW1UuC3xKM5btMSIObGhNcE9qIWjyqZkRQURPeysfVDCvFayUZP6ue5XyDMWGUqqfVGcUUc8HUrPo5j3moF30PdnAHCJAzij36MiQzwNZBRkNEy90-xQOgq-VXtIY8uLBFJnRoBRbcfpgKVpBHP-T3aGFjiDtn0WUw_ja7X3IGrQpfwj-gQ_MYhhS9L9d1csY_r570xmd4cTrPq_XHxXp-VV9__rScX17XlrdqqFUjpWg2rQRpmOGCG0IJlbw1VIqu7xjfkL7roWtB9YZjzKllggK2GDcA7Lz6cJTdj5sddBbKFMbrfXI7k251NE7_nQnum97Gg6aqaTnhReDiJJDi97GsQe9ctuC9CRDHrCVjjIhGikK-_oe8iWMq-8haSUIL08gCkSNkU8w5QX8_CsF6slcf7dV4ehd79ST86s8_3Ff89rMAb06Aydb4PplgXX7gaKvalk3N6ZHLJRW2kB4m_H_3O2L-vnE</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Sanders, Gillian D.</creator><creator>Anaya, Henry D.</creator><creator>Asch, Steven</creator><creator>Hoang, Tuyen</creator><creator>Golden, Joya F.</creator><creator>Bayoumi, Ahmed M.</creator><creator>Owens, Douglas K.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100601</creationdate><title>Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial</title><author>Sanders, Gillian D. ; Anaya, Henry D. ; Asch, Steven ; Hoang, Tuyen ; Golden, Joya F. ; Bayoumi, Ahmed M. ; Owens, Douglas K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-867756b97e7a3a454a1212749a275dfd34b1fdfed9e8fa40042c352e0c006ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Antiretroviral drugs</topic><topic>Biological and medical sciences</topic><topic>Cost control</topic><topic>Cost-Benefit Analysis</topic><topic>Economic analysis</topic><topic>General aspects</topic><topic>HIV</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - economics</topic><topic>HIV Infections - therapy</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Markov Chains</topic><topic>Mass Screening - economics</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Medical tests</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>Original</topic><topic>Original Article</topic><topic>Patient Acceptance of Health Care</topic><topic>Patient Compliance</topic><topic>Prevention and actions</topic><topic>Primary care</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Sensitivity analysis</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanders, Gillian D.</creatorcontrib><creatorcontrib>Anaya, Henry D.</creatorcontrib><creatorcontrib>Asch, Steven</creatorcontrib><creatorcontrib>Hoang, Tuyen</creatorcontrib><creatorcontrib>Golden, Joya F.</creatorcontrib><creatorcontrib>Bayoumi, Ahmed M.</creatorcontrib><creatorcontrib>Owens, Douglas K.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanders, Gillian D.</au><au>Anaya, Henry D.</au><au>Asch, Steven</au><au>Hoang, Tuyen</au><au>Golden, Joya F.</au><au>Bayoumi, Ahmed M.</au><au>Owens, Douglas K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>25</volume><issue>6</issue><spage>556</spage><epage>563</epage><pages>556-563</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>Background
The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results.
Objective
To examine the costs and benefits of strategies to improve HIV testing and receipt of results.
Design
Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.
Setting/target population
Primary-care patients with unknown HIV status.
Interventions
Comparison of three intervention models for HIV counseling and testing: Model A = traditional HIV counseling and testing; Model B = nurse-initiated routine screening with traditional HIV testing and counseling; Model C = nurse-initiated routine screening with rapid HIV testing and streamlined counseling.
Main measures
Life-years, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness.
Key results
Without consideration of the benefit from reduced HIV transmission, Model A resulted in per-patient lifetime discounted costs of $48,650 and benefits of 16.271 QALYs. Model B increased lifetime costs by $53 and benefits by 0.0013 QALYs (corresponding to 0.48 quality-adjusted life days). Model C cost $66 more than Model A with an increase of 0.0018 QALYs (0.66 quality-adjusted life days) and an incremental cost-effectiveness of $36,390/QALY. When we included the benefit from reduced HIV transmission, Model C cost $10,660/QALY relative to Model A. The cost-effectiveness of Model C was robust in sensitivity analyses.
Conclusions
In a primary-care population, nurse-initiated routine screening with rapid HIV testing and streamlined counseling increased rates of testing and receipt of test results and was cost-effective compared with traditional HIV testing strategies.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20204538</pmid><doi>10.1007/s11606-010-1265-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0884-8734 1525-1497 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
| subjects | Adult Antiretroviral drugs Biological and medical sciences Cost control Cost-Benefit Analysis Economic analysis General aspects HIV HIV Infections - diagnosis HIV Infections - economics HIV Infections - therapy Human immunodeficiency virus Human viral diseases Humans Infectious diseases Internal Medicine Male Markov Chains Mass Screening - economics Medical sciences Medical screening Medical tests Medicine Medicine & Public Health Middle Aged Nursing Original Original Article Patient Acceptance of Health Care Patient Compliance Prevention and actions Primary care Public health. Hygiene Public health. Hygiene-occupational medicine Sensitivity analysis Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Cost-Effectiveness of Strategies to Improve HIV Testing and Receipt of Results: Economic Analysis of a Randomized Controlled Trial |
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