Abstract
Objective. - To compare tuberculin screening of all kindergartners and high school entrants (screen-all strategy) vs screening limited to high-risk children (targeted screening). Design. - Decision, cost-effectiveness, and cost-benefit analyses. Setting and Subjects. - Students in a large urban and rural county. Definitions. - High risk of tuberculous infection was defined as birth in a country with a high prevalence of tuberculosis. Low risk was defined as birth in the United States. Outcome Measures. - Tuberculosis cases prevented per 10 000 children screened. Net costs, net cost per case prevented, benefit-cost ratio, and incremental cost-effectiveness. Results. - The screen-all strategy would prevent 14.9 cases per 10 000 children screened; targeted screening would prevent 84.9 cases per 10 000 children screened. The screen-all strategy is more costly than no screening; the benefit-cost ratio is 0.58. Targeted screening would result in a net savings; the benefit-cost ratio is 1.2. Screening all children is cost saving only if the reactor rate is 20% or greater. The cost per additional case prevented for screening all children compared with targeted screening ($34 666) is more than twice as high as treatment and contact tracing for a case of tuberculosis ($16 392). Conclusions. - Targeted screening of schoolchildren is much less costly than mass screening and is more efficient in prevention of tuberculosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 613-619 |
| Number of pages | 7 |
| Journal | Journal of the American Medical Association |
| Volume | 274 |
| Issue number | 8 |
| State | Published - 1995 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
School-based screening for tuberculous infection : A cost-benefit analysis. / Mohle-Boetani, J. C.; Miller, B.; Halpern, Michael; Trivedi, A.; Lessler, J.; Solomon, S. L.; Fenstersheib, M.
In: Journal of the American Medical Association, Vol. 274, No. 8, 1995, p. 613-619.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - School-based screening for tuberculous infection
T2 - A cost-benefit analysis
AU - Mohle-Boetani, J. C.
AU - Miller, B.
AU - Halpern, Michael
AU - Trivedi, A.
AU - Lessler, J.
AU - Solomon, S. L.
AU - Fenstersheib, M.
PY - 1995
Y1 - 1995
N2 - Objective. - To compare tuberculin screening of all kindergartners and high school entrants (screen-all strategy) vs screening limited to high-risk children (targeted screening). Design. - Decision, cost-effectiveness, and cost-benefit analyses. Setting and Subjects. - Students in a large urban and rural county. Definitions. - High risk of tuberculous infection was defined as birth in a country with a high prevalence of tuberculosis. Low risk was defined as birth in the United States. Outcome Measures. - Tuberculosis cases prevented per 10 000 children screened. Net costs, net cost per case prevented, benefit-cost ratio, and incremental cost-effectiveness. Results. - The screen-all strategy would prevent 14.9 cases per 10 000 children screened; targeted screening would prevent 84.9 cases per 10 000 children screened. The screen-all strategy is more costly than no screening; the benefit-cost ratio is 0.58. Targeted screening would result in a net savings; the benefit-cost ratio is 1.2. Screening all children is cost saving only if the reactor rate is 20% or greater. The cost per additional case prevented for screening all children compared with targeted screening ($34 666) is more than twice as high as treatment and contact tracing for a case of tuberculosis ($16 392). Conclusions. - Targeted screening of schoolchildren is much less costly than mass screening and is more efficient in prevention of tuberculosis.
AB - Objective. - To compare tuberculin screening of all kindergartners and high school entrants (screen-all strategy) vs screening limited to high-risk children (targeted screening). Design. - Decision, cost-effectiveness, and cost-benefit analyses. Setting and Subjects. - Students in a large urban and rural county. Definitions. - High risk of tuberculous infection was defined as birth in a country with a high prevalence of tuberculosis. Low risk was defined as birth in the United States. Outcome Measures. - Tuberculosis cases prevented per 10 000 children screened. Net costs, net cost per case prevented, benefit-cost ratio, and incremental cost-effectiveness. Results. - The screen-all strategy would prevent 14.9 cases per 10 000 children screened; targeted screening would prevent 84.9 cases per 10 000 children screened. The screen-all strategy is more costly than no screening; the benefit-cost ratio is 0.58. Targeted screening would result in a net savings; the benefit-cost ratio is 1.2. Screening all children is cost saving only if the reactor rate is 20% or greater. The cost per additional case prevented for screening all children compared with targeted screening ($34 666) is more than twice as high as treatment and contact tracing for a case of tuberculosis ($16 392). Conclusions. - Targeted screening of schoolchildren is much less costly than mass screening and is more efficient in prevention of tuberculosis.
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UR - http://www.scopus.com/inward/citedby.url?scp=0029146189&partnerID=8YFLogxK
M3 - Article
C2 - 7637141
AN - SCOPUS:0029146189
VL - 274
SP - 613
EP - 619
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0002-9955
IS - 8
ER -