title: Estimating the cost to U.S. health departments to conduct HIV surveillance.
abstract: OBJECTIVE
  HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance.
  
  
  METHODS
  We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale.
  
  
  RESULTS
  We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites.
  
  
  CONCLUSIONS
  Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: Ram K
authors.initials: RK
authors.lastname: Shrestha
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Sansom
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Laffoon
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Farnham
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: R Luke
authors.initials: RL
authors.lastname: Shouse
authors.affiliation: Michigan Department of Community Health, Lansing, MI.
authors.forename: Karen
authors.initials: K
authors.lastname: MacMaster
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
mesh_terms: D003365:Costs and Cost Analysis / Q000379:methods*; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D011159:Population Surveillance; D011635:Public Health Administration / Q000191:economics*