title: A cost comparison analysis for screening and vaccination of hospital personnel with high- and low-prevalence hepatitis B virus antibodies in California.
abstract: We compared the cost of antibody screening and the projected cost for hepatitis B vaccination of antibody-negative individuals at hospitals with "high prevalence" and "low prevalence" rates for hepatitis B virus antibodies among their employees. The use of hepatitis B core antibody for screening and subsequent hepatitis B vaccination of antibody-negative personnel was most cost-effective for hospitals considered to have high prevalence for hepatitis B virus antibodies among its staff, although use of hepatitis B surface antibody in this setting only increased costs by 1.4%. In a hospital with low prevalence for hepatitis B virus antibodies among its staff, use of hepatitis B surface antibody and subsequent vaccination of antibody-negative individuals was the most cost-effective approach, while use of hepatitis B core antibody for the above purposes would have increased costs by 3.4%. The use of both hepatitis B surface antibody and core antibody in either setting followed by immunization was least economical, as costs were increased by 13% and 13.5% respectively. We concluded that hepatitis B core antibody should be used for screening in hospitals with high prevalence for hepatitis B virus antibodies among employees while hepatitis B surface antibody be used for screening in hospitals with low prevalence for hepatitis B virus antibodies among employees. A prediction of high and low prevalence for hepatitis B virus antibodies in hospital personnel may be made by knowledge of the distribution in ethnicity of staff.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D003362:Cost-Benefit Analysis; D005260:Female; D006509:Hepatitis B / Q000191:economics* / Q000208:ethnology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000008:administration & dosage / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D010564:Personnel, Hospital; D014611:Vaccination / Q000191:economics*
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens