Cost comparisons between home- and clinic-based testing for sexually transmitted diseases in high-risk young women

Abstract

Home testing for chlamydia and gonorrhea increasesscreening rates, but the cost consequences of this interventionare unclear. We examined the cost differences between home-basedand clinic-based testing and the cost-effectiveness of hometesting based on the DAISY study, a randomized controlled trial.Direct and indirect costs were estimated for home and clinictesting, and cost-effectiveness was calculated as cost peradditional test performed. In the clinic testing group, directcosts were $49/test and indirect costs (the costs of seekingor receiving care) were $62/test. Home testing cost was$25/test. We found that home testing was cost saving when alltesting for all patients was considered. However cost savings werenot seen when only asymptomatic tests or when patient subgroupswere considered. A home testing program could be cost saving,depending on whether changes in clinic testing frequency occurwhen home testing is available. Copyright © 2007 Kenneth J. Smith et al.