221207 A Cost Study of Integrating Family Planning Services into an STD Visit

Tuesday, November 9, 2010 : 8:50 AM - 9:10 AM

Hai Fang, PhD , Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Aurora, CO
Deborah Rinehart , Health Services Research, Denver Health, Denver, CO
Deborah Bell, WHCNP , Denver Public Health Department, Denver Health, Denver, CO
Dean McEwen, MBA , Denver Public Health Department, Denver Health, Denver, CO
Sharon Devine, JD, PhD , Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO
Susan L. Dreisbach, PhD , Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO
Theresa Mickiewicz, MSPH , Denver Public Health Department, Denver Health, Denver, CO
Moises Maravi, MS , Denver Public Health Department, Denver Health, Denver, CO
Judith Shlay, MD, MSPH , Denver Department of Public Health, Denver, CO
Background: Most STD clinics focus solely on STD treatment and prevention, although family planning services (FPS) are also needed for many of these patients. Behaviors attributing to the need for STD and FPS services are similar; therefore integration of these services is logical. Denver Metro Health Clinic (DMHC) has utilized Title X funding to integrate FPS into an STD visit for eligible patients. FPS includes preconception counseling, pregnancy testing, contraceptive counseling, and provision of birth control methods.

Objectives: To measure the costs of integrating FPS within the STD visit.

Methods: DMHC collected service information for 530 patient visits during three weeks in December 2009. Staff time was measured separately for registration, triage, phlebotomy and clinical services. Multivariate analysis and propensity score matching were used to identify the additional time cost for integrating FPS into an STD visit.

Results: 187 patients received STD services and 343 patients received integrated services. Average time was 28.21 (SDą15)minutes for an STD visit and 34.03 (SDą 15) minutes for an integrated visit (p< 0.01 by t-test). Average cost was $15.77 (SDą10)for an STD visit and $18.62 (SDą10) for an integrated visit (p< 0.01 by t-test). Additional time of integrating FPS into an STD visit was 5.82 minutes with the additional cost being $2.85. Multivariate regression after propensity score matching reveals an even smaller difference: 4.20 minutes ($2.72) after controlling for confounding variables.

Discussion: Integration of FPS with STD services is more cost-effective and time-efficient than offering these services in separate clinical visits.

Learning Areas:
Biostatistics, economics
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
Identify the additional time and cost needed to integrate family planning services into an STD visit.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the health economist for the project and I oversee the economic analysis of the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4056.0: Beyond family planning