Using cost analysis to prioritize cost saving strategies by local health departments in delivering STI services

Sexually transmitted infections (STI) continue to be a major public health problem; however, STI funding has been decreasing in recent years. Finding more cost effective means of providing the services that do not diminish, and may even improve public health outcomes is critical at this time of major budget challenges to local public health systems. 

Study Design: Our initial approach used macro-level county data on expenditures related to delivering STI services to identify variations in costs by county per reported STI case (average).  This was followed by an in-depth analysis to explain the variations identified in the macro-level data.  This included analyzing detailed cost data on each process of providing STI services (field work, treatment verification, partner notification), types of personnel providing the service, and other demographic or local factors that may impact the cost of service.  Verification of these factors was performed through detailed interviews and surveys with local health department key informants.

 Implications: State and local policy makers are pressed to shift resources to absorb cuts in public health funding in addition to dealing with new and emerging health issues.  Results from this study provide promising insights concerning opportunities to reduce waste and redundancy, while maintaining or enhancing the quality of services.  Plans are underway to use the results of this Florida PBRN project  to identify and prioritize cost saving strategies for STI services through local health department engaged processes, leading to a cost effectiveness study that will yield actionable findings for public health practice.