title: A cost-effectiveness analysis of interventions to increase repeat testing in patients treated for gonorrhea or chlamydia at public sexually transmitted disease clinics.
abstract: BACKGROUND
  Persons who have been infected with chlamydia or gonorrhea (CT/GC) are at elevated risk for reinfection. The cost-effectiveness of interventions designed to encourage public sexually transmitted disease (STD) clinic patients to return for rescreening has not been well-evaluated.
  
  
  OBJECTIVE
  The goal of this study was to conduct a program- and societal-perspective cost-effectiveness analysis of five interventions designed to encourage public STD clinic patients infected with CT/GC to return for rescreening 3 months after initial treatment.
  
  
  METHODS
  Researchers at two STD clinics collected cost data for the five interventions. These were combined with study data on return rates and CT/GC positivity rates among returning patients to compare the cost-effectiveness of the interventions.
  
  
  RESULTS
  The cost per patient counseled with a brief recommendation to return, followed by a telephone reminder after 3 months, was higher than two interventions: a brief recommendation to return with no reminder and a $20 incentive, received on return. However, the brief recommendation with a telephone reminder yielded the highest return rate (33%) and was the least costly in terms of cost per infection treated ($622 program, $813 societal). In-depth motivational counseling that helped clients identify risk factors and provided reasons for returning was more costly than a phone reminder alone and was not more effective.
  
  
  CONCLUSIONS
  Phone reminders are more cost-effective than motivational counseling and improve return rates over a brief recommendation given at the time of initial treatment.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tgift@cdc.gov
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Gift
authors.forename: C Kevin
authors.initials: CK
authors.lastname: Malotte
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ledsky
authors.forename: Matthew
authors.initials: M
authors.lastname: Hogben
authors.forename: Susan
authors.initials: S
authors.lastname: Middlestadt
authors.forename: Nancy L
authors.initials: NL
authors.lastname: VanDevanter
authors.forename: Janet S
authors.initials: JS
authors.lastname: St Lawrence
mesh_terms: D002690:Chlamydia Infections / Q000191:economics* / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D003376:Counseling / Q000191:economics; D006069:Gonorrhea / Q000191:economics* / Q000517:prevention & control*; D006801:Humans; D009042:Motivation; D015397:Program Evaluation / Q000191:economics; D017010:Reminder Systems / Q000191:economics; D013689:Telephone / Q000191:economics