An economic evaluation of a school-based sexually transmitted disease screening program.
BACKGROUND
A school-based sexually transmitted disease (STD) screening program was implemented in eight New Orleans public high schools to detect chlamydia and gonorrhea.


OBJECTIVE
The goal was to assess the incremental cost-effectiveness of replacing non-school-based screening with the school-based screening program.


METHODS
A decision-analysis model was constructed to compare costs and cases of expected pelvic inflammatory disease (PID) in the school-based screening scenario versus a non-school-based screening scenario. Cost-effectiveness was quantified and measured as cost per case of PID prevented.


RESULTS
Under base-case assumptions, at an intervention cost of $86,449, the school screening program prevented an estimated 38 cases of PID, as well as $119,866 in treatment costs for PID and its sequelae, resulting in savings of $1524 per case of PID prevented. Results remained cost-saving over a reasonable range of model parameter estimates.


CONCLUSIONS
The New Orleans school-based chlamydia screening program was cost-effective and cost-saving and could be cost-effective in other settings. School-based screening programs of this type are likely to be a cost-effective use of public funds and can reduce the burden of STDs among adolescents.
Wang
Li Yan
LY
Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lgw0@cdc.gov
Burstein
Gale R
GR
Cohen
Deborah A
DA
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000592:standards; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies; D012572:School Health Services / Q000191:economics*; D012680:Sensitivity and Specificity