A cost-based decision analysis for Chlamydia screening in California family planning clinics.
Antibody-based methods for the diagnosis of Chlamydia trachomatis infection of the cervix have recently made population screening programs possible for this epidemic and frequently asymptomatic problem. We constructed a decision model, using medical care costs as utilities, to determine the total costs of screening and of not screening in California state-funded family planning clinics, and to determine the prevalence of infection at which such screening could be expected to pay for itself. A net savings of $6 million would be realized in the first year, with annual savings eventually increasing to over $13 million, from the prevention of chlamydia-associated pelvic inflammatory disease and other long-term sequelae such as tubal infertility and ectopic pregnancy. Over $60 million could be saved in the first five years of such a statewide screening program. In populations with infection prevalence of 2% or more, such screening will pay for itself and can be considered "cost-effective." Screening of asymptomatic women for chlamydia should be carried out in most American family planning clinics.
D002690:Chlamydia Infections / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003663:Decision Trees; D005193:Family Planning Services; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000191:economics / Q000517:prevention & control*