title: Screening for childhood lead poisoning: a cost-minimization analysis.
abstract: Decision analysis was used to compare the costs of three screening strategies for childhood lead poisoning: (1) venipuncture; (2) capillary sample with venipuncture confirmation if the blood lead level is elevated; (3) stratification by risk, with venipuncture for high-risk children and capillary sample for low-risk children. Under baseline conditions, the cost of screening by the venipuncture, stratification, and capillary strategies is $22, $25, and $27, respectively. Venipuncture remains the least expensive strategy unless the cost of venipuncture is more than three times that of capillary sampling. The annual cost of a national lead screening program that uses a single venipuncture sample would be $352 million. Initial screening with a capillary sample would cost $432 million, 23% more than venipuncture.
authors.affiliation: Department of Pediatrics, Boston City Hospital, MA 02118.
authors.forename: D E
authors.initials: DE
authors.lastname: Glotzer
authors.forename: H
authors.initials: H
authors.lastname: Bauchner
authors.forename: K A
authors.initials: KA
authors.lastname: Freedberg
authors.forename: S
authors.initials: S
authors.lastname: Palfrey
mesh_terms: D001800:Blood Specimen Collection / Q000191:economics* / Q000379:methods; D002648:Child; D017046:Cost Savings; D003661:Decision Support Techniques; D005189:False Positive Reactions; D006801:Humans; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000175:diagnosis*; D008403:Mass Screening / Q000191:economics* / Q000379:methods
chemical_list: D007854:Lead