1 / 12

Cost-Effectiveness Evaluation of Syphilis Screening at Cook County Jail

Cost-Effectiveness Evaluation of Syphilis Screening at Cook County Jail. J Kraut 1 , A McIntyre 2 , H Beidinger 3,4 , K Irwin 3 1 Northern Illinois University, DeKalb, IL 2 University of Illinois at Chicago School of Public Health 3 Centers for Disease Control and Prevention, Atlanta, GA

talib
Download Presentation

Cost-Effectiveness Evaluation of Syphilis Screening at Cook County Jail

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Cost-Effectiveness Evaluation of Syphilis Screening at Cook County Jail J Kraut1, A McIntyre2, H Beidinger3,4, K Irwin3 1 Northern Illinois University, DeKalb, IL 2 University of Illinois at Chicago School of Public Health 3Centers for Disease Control and Prevention, Atlanta, GA 4 Chicago Department of Public Health

  2. Background • 1987: Routine syphilis screening for all detainees by Chicago Dept of Public Health (CDPH) • 1996: High rates of early syphilis detected at Cook County Jail (CCJ)  “Stat RPR Project” • CDPH Disease Intervention Specialist at Women’s Intake Unit • Pilot Program with limited scope • Women • Second work shift (3 PM - 11 PM), M-F

  3. Results of Stat RPR Project • Percent of detainees treated prior to release from jail*: • Routine RPR: 44% • Stat RPR: 88% • New cases of early syphilis declining • 1996: 152 cases • 1999: 139 cases • High recidivism • Is Stat RPR screening still valuable? *MMWR, June 5, 1998

  4. Objectives • Determine the cost and cost effectiveness of Stat RPR vs. Routine RPR screening for syphilis in female inmates • Evaluate long-term value of Stat RPR screening at CCJ

  5. Decision Analysis Model: Program Alternatives • Program Alternative 1 • Stat RPR Screening  2nd shift • Voluntary specimen collection at women’s intake unit • RPR Testing—immediately—at women’s intake unit • Treatment within hours of arrival • TOTAL TIME: Several Hours • Routine RPR Screening  All other shifts • Voluntary specimen collection at women’s intake unit • RPR Testing—next day—at onsite lab • Results back within a few days • Location and movement of detainee for treatment • TOTAL TIME: 3-4 Days • Program Alternative 2 • Routine RPR Screening  All shifts

  6. Methods: Data • RPR Test Data • RPR Test results provided by CDPH and lab onsite at CCJ • RPR Test performance measures: Literature estimates • Costs • Labor costs: Time-Motion studies at CCJ [3/7/00-4/3/00] • Laboratory Technician • Correctional Medical Technician • Disease Intervention Specialists (DIS) • Jail-Based STD Clinic • Field Follow Up (+RPRs Released Prior to Treatment) • Stat RPR Project: Women’s Intake Unit • Tests, Treatment, Equipment: CDPH • Sequelae Costs: Literature estimates

  7. Methods: Data • Detainee Data • Collected by CDPH [March 7 – April 3, 2000] • Demographics • Age, Race, Education, Number of Children • Booking Data • Length of stay at CCJ • Reason for this arrest • Number of previous arrests within past 3 years

  8. Results: Program Characteristics

  9. Results

  10. Limitations • Small sample size • Potential measurement error in data • All data elements manually collected • Lab results not automated • Data not centralized

  11. Ongoing Data Collection • 1996 – 2000 Data • Examine cost to detect new case of syphilis in 1996 vs. cost to detect new case of syphilis in 2000 • Examine cost effectiveness of Stat RPR screening in 1996 vs. cost effectiveness of Stat RPR in 2000

  12. Conclusions • Stat RPR screening is effective way to treat inmates prior to release from jail • Cost of Stat RPR screening > Routine RPR screening • Cases detected and treated with Stat RPR screening > Cases detected and treated with Routine RPR screening • Other issues surrounding jail, syphilis control influence programming decisions • Local decision-makers must decide whether Stat RPR screening can be sustained given their budget

More Related