Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-26T06:09:04.901Z Has data issue: false hasContentIssue false

Emergency Department Management of Occupational Exposures: Cost Analysis of Rapid HIV Test

Published online by Cambridge University Press:  02 January 2015

J. Celeste Kallenborn
Affiliation:
Department of Emergency Medicine, University of Louisville, School of Medicine, University of Louisville, College of Business and Puplic Administration, Louisville, Kentucky
Timothy G. Price*
Affiliation:
Department of Emergency Medicine, University of Louisville, School of Medicine, University of Louisville, College of Business and Puplic Administration, Louisville, Kentucky
Ruth Carrico
Affiliation:
University of Louisville Hospital, University of Louisville, College of Business and Puplic Administration, Louisville, Kentucky
Audrey B. Davidson
Affiliation:
Department of Economics, University of Louisville, College of Business and Puplic Administration, Louisville, Kentucky
*
University of Louisville, Department of Emergency Medicine, 530 S Jackson, Louisville, KY 40202

Abstract

Objective:

To compare costs for evaluation and treatment of a healthcare worker (HCW) experiencing an occupational exposure, using a rapid human immunodeficiency virus (HIV) test versus a standard enzyme-linked immunosorbent assay (ELISA) HIV test.

Design:

Retrospective chart review of all HCWs presenting to the emergency department (ED) for care of an occupational exposure over a 13-month period.

Setting:

A 404-bed university-based level 1 trauma center with an annual ED census of approximately 35,000.

Participants:

All HCWs experiencing an occupational exposure treated in the ED using a rapid HPV protocol were included in the analysis.

Methods:

A calculation of selected costs of the initial evaluation and treatment of patients whose evaluation included a rapid HIV test on the source patient were performed. A similar calculation was then made for these patients, had the standard ELISA test been used. Evaluated costs included laboratory tests, postexposure prophylactic medications, and estimated lost work time. Other costs were constant and were not included in the evaluation.

Results:

Total evaluated cost using the rapid HIV test as part of the evaluation and treatment protocol was $465.80 for 17 patients. Had the ELISA test been used instead of the rapid test, the total evaluated cost for the 17 patients would have been $5,965.81.

Conclusions:

When used as part of the evaluation and treatment of the HCW with an occupational exposure, the rapid HIV test results in substantial cost savings over the ELISA test.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. EPINET. Centers for Disease Control and Prevention. Annual number of occupational percutaneous injuries and mucocutaneous exposures as potentially infective biological substances (1996). http://www.med.virginia.edu/medcntr/centers/epinet/estimates.html. Last updated June 15, 1998.Google Scholar
2.Centers For Disease Control and Prevention. Public health service guidelines for the management of health-care workers exposures to HIV and recommendations for postexposure prophylaxis. MMWR 1998;47(RR-7):134. http://www.cdc.gov/mmwr/PDF/RR/RR4707.pdf.Google Scholar
3.Schriger, DL, Baraff, LJ, Rogers, WH, Coltin, S. Implementation of clinical guidelines using a computer charting system. JAMA 1997;278:15851590.Google Scholar
4.Kallenborn, JC, Coleman, RD, Carrico, R, Smith, AM, Ferriell, K. Occupational exposure: organizing ED care to determine rapid post exposure prophylaxis within hours instead of days. J Emerg Nurs 1999;25:505508.Google Scholar
5.Murex Diagnostics, Inc. Human immunodeficiency virus type 1 SUDS®HIV-1 test. Manufacturer package insert, page 13. Norcross, GA: Murex Diagnostics, Inc.Google Scholar
6.Pinkerton, SD, Holtgrave, DR, Pinkerton, HJ. Cost-effectiveness of chemoprophylaxis after occupational exposure to HIV. Arch Intern Med 1997;157:19721980.Google Scholar
7.Henry, K, Thurn, J. HIV infection in healthcare workers: how great is the risk? What can be done before and after exposure? Postgrad Med 1991;89:3038.CrossRefGoogle ScholarPubMed
8.Lorie, P, Miller, S, Hecht, F, Chesney, M, Lo, B. Post exposure prophylaxis after nonoccupational HIV exposure: clinical, ethical and policy considerations. JAMA 1998;280:17691773.Google Scholar
9.Centers For Disease Control and Prevention. Rapid HIV tests: issues for counselors providing HIV prevention counseling. http://www.cdc.gov/hiv/pubs/rt/rapidct.htm. Last updated March 27, 1998.Google Scholar