A Cost-Effective Analysis of Interventions to Increase Repeat Testing in Patients Treated for Gonorrhea or Chlamydia at Public Sexually Transmitted Disease Clinics
October 3, 2005
Since persons who have been infected with chlamydia or gonorrhea (CT/GC) are at increased risk for reinfection, the authors of the current study sought to conduct a program- and societal-perspective cost-effectiveness analysis of five interventions designed to encourage public STD clinic patients to return for rescreening three months after initial treatment.
Cost data for the five interventions were collected at two STD clinics. These were combined with study data on return rates and CT/GC positivity rates among returning patients to compare the cost-effectiveness of the interventions.
"The cost per patient counseled with a brief recommendation to return, followed by a telephone reminder after three months, was higher than two interventions: a brief recommendation to return with no reminder and a $20 incentive, received on return," the researchers reported. Brief recommendation with a telephone reminder produced the highest return rate (33 percent) and was least costly in terms of cost per infection treated ($622 program, $813 societal). In-depth motivational counseling that helped patients identify risk factors and provided reasons for returning was costlier than a phone reminder alone and was no more effective.
"Phone reminders are more cost-effective than motivational counseling and improve return rates over a brief recommendation given at the time of initial treatment," the authors concluded.
Sexually Transmitted Diseases
09.05; Vol. 32, No. 9: P. 542-549; Thomas L. Gift, Ph.D.; Kevin C. Malotte, Dr.P.H.; Rebecca Ledsky, M.B.A.; Matthew Hogben, Ph.D.; Susan Middlestadt, Ph.D.; Nancy L. VanDevanter, Dr.P.H.; Janet S. St. Lawrence, Ph.D.; The GCAP Study Group