title: Models of community-based hepatitis B surface antigen screening programs in the U.S. and their estimated outcomes and costs.
abstract: OBJECTIVE
  Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs.
  
  
  METHODS
  We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening.
  
  
  RESULTS
  The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive.
  
  
  CONCLUSIONS
  Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings.
authors.affiliation: RTI International, 2951 Flowers Rd., Ste. 119, Atlanta, GA 30341, USA. drein@rti.org
authors.forename: David B
authors.initials: DB
authors.lastname: Rein
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Lesesne
authors.forename: Bryce D
authors.initials: BD
authors.lastname: Smith
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Weinbaum
mesh_terms: D000367:Age Factors; D003362:Cost-Benefit Analysis; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000175:diagnosis* / Q000208:ethnology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D006514:Hepatitis B Surface Antigens