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The health care and patient costs of an proactive chlamydia screening programme: the Chlamydia Screening Studies (ClaSS) project
  1. Suzanne M Robinson (s.m.robinson{at}bham.ac.uk)
  1. University of Birmingham, United Kingdom
    1. Tracy E Roberts (t.e.roberts{at}bham.ac.uk)
    1. University of Birmingham, United Kingdom
      1. Pelham M Barton (p.m.barton{at}bham.ac.uk)
      1. University of Birmingham, United Kingdom
        1. Stirling Bryan (s.bryan{at}bham.ac.uk)
        1. University of Birmingham, United Kingdom
          1. John A Macleod (macleoja{at}adf.bham.ac.uk)
          1. University of Birmingham, United Kingdom
            1. Anne McCarthy (anne.mccarthy{at}bristol.ac.uk)
            1. University of Bristol, United Kingdom
              1. Matthias Egger (egger{at}ispm.unibe.ch)
              1. University of Bern, Switzerland
                1. Emma Sanford (emma.sanford{at}bristol.ac.uk)
                1. University of Bristol, United Kingdom
                  1. Nicola Low (nicola.low{at}bristol.ac.uk)
                  1. University of Bern, Switzerland

                    Abstract

                    Objectives: Most economic evaluations of chlamydia screening do not include costs incurred by patients. The objectives of this study were to estimate both the health service and private costs of patients who participated in proactive chlamydia screening using mailed home-collected specimens as part of the Chlamydia Screening Studies (ClaSS) project.

                    Methods: We collected data on the administrative costs of the screening study, and conducted laboratory time and motion studies and patient cost questionnaire surveys. We estimated the cost per screening invitation and per accepted offer. One way sensitivity analysis was conducted to explore the effects of variations in patient costs and the number of patients accepting the screening offer.

                    Results: The time and costs of processing urine specimens and vulvo-vaginal swabs from women using two nucleic acid amplification tests were similar. The total cost per screening invitation was £20.37 (95%CI £18.94 to 24.83). This included the National Health Service (NHS) cost per individual screening invitation (£13.55, 95%CI £13.15 to 14.33) and average patient costs of £6.82 (95%CI £5.43 to 10.22). Administrative costs accounted for 55% of the overall cost.

                    Conclusions: Proactive chlamydia screening is not more expensive than opportunistic screening. Results from this study, which is the first to collect private patient costs associated with a chlamydia screening programme, could be used to inform future policy recommendations and provide unique primary cost data for economic evaluations.

                    • Chlamydia
                    • cost analysis
                    • diagnostic testing
                    • patient cost
                    • screening

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