title: Cost analysis of enhancing linkages to HIV care following jail: a cost-effective intervention.
abstract: We are not aware of published cost-effectiveness studies addressing community transitional programs for HIV-infected jail detainees. To address this gap, data from 9 sites of EnhanceLink, a project that enrolled HIV-infected releasees from jails across the US, were examined. Figures on the number of clients served, cost of linkage services, number of linkages and 6-month sustained linkages to community HIV care, and number of clients achieving viral suppression were assessed for subjects released in the first quarter of 2010 (n = 543). The cost analysis included all costs that participating service agencies incurred. A cost-effectiveness analysis was conducted to estimate the new HIV cases averted by EnhanceLink and the cost per quality-adjusted life year saved by the program. The mean cost per linked client was $4,219; the mean cost per 6-month sustained linkage was $4,670; and the mean cost per client achieving viral suppression was $8,432. Compared to standard care, the cost per additional quality-adjusted life year saved was $72,285, suggesting that the EnhanceLink interventions were cost-effective from the societal perspective.
authors.affiliation: Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA, aspauld@emory.edu.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Spaulding
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pinkerton
authors.forename: Hillary
authors.initials: H
authors.lastname: Superak
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Cunningham
authors.forename: Stephen
authors.initials: S
authors.lastname: Resch
authors.forename: Alison O
authors.initials: AO
authors.lastname: Jordan
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011330:Prisons; D015397:Program Evaluation; D019057:Quality-Adjusted Life Years; D012944:Social Support; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents