This study describes the costs and outcomes of community-based tuberculin screening programs conducted between 1987 and 1991 in Montreal, Quebec, Canada.
Follow-up information was abstracted from hospital records of all reactors detected in tuberculin screening of students in grades 6 and 10, of first-year health professional students, and of workers aged 18 to 25 in a number of workforces.
Screening costs were estimated directly from survey records, and follow-up costs were estimated from the annual financial report of the Montreal Chest Hospital for 1989/90.
Of 7669 persons tested, 782 (10.2%) had positive results and 757 (9.9%) were referred to a clinic.
Of those, 525 (6.8% of the original 7669) reported, 293 (3.8%) were prescribed therapy, and 154 (2.0%) were compliant.
In Canadian dollars, screening cost $5.70 per person tested and $56 per tuberculin reactor detected, but follow-up of reactors accounted for 73% of the total program cost of $13 455 to $18 753 per case of tuberculosis prevented.
Because of high rates of patient and provider noncompliance, a tuberculin screening program was much less cost-effective than anticipated.
Screening costs must be targeted to the highest risk populations, and compliance with recommendations for preventive therapy must be maximized.
Mots-clés Pascal : Programme sanitaire, Dépistage, Tuberculine, Tuberculose, Mycobactériose, Bactériose, Infection, Evaluation, Analyse coût, Economie santé, Québec, Canada, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Sanitary program, Medical screening, Tuberculin, Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Evaluation, Cost analysis, Health economy, Quebec, Canada, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0348999
Code Inist : 002B05B02E. Création : 01/03/1996.