Online Program

HIV Rapid Testing in a VA Emergency Department and Primary Care Department Setting: Cost Analysis at Five Years

Tuesday, November 3, 2015 : 11:30 a.m. - 11:50 a.m.

Kee Chan, PhD, Department of Health Policy and Administration, Doctor of Public Health (DrPH) Leadership, University of Illinois, Chicago School of Public Health, Chicago, IL
Herschel Knapp, PhD, MSSW, Quality Enhancement Research Initiative for HIV and Hepatitis (QUERI-HIV/HEP), US Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, CA
Patients with HIV benefit from early diagnosis, however, the approach and cost of implementation of the HIV testing is often unknown. Thus, this study explored the implementation of the HIV oral rapid testing in the primary care setting and Emergency Department in the US Veterans Affairs Healthcare System.  We conducted a comprehensive cost-minimization analysis to comprehend the financial attributes of the first five years of these implementations wherein nurses  administered HIV oral rapid tests (RT) to patients in the ED and primary care setting.  Deidentified quantitative data was gathered from the electronic medical records detailing quarterly HIV rapid testing rates in the ED setting and primary care settings spanning the first five years. At five years, a total of 2,620 HIV RTs had been administered  in the ED and 2,117  in the primary setting. Despite quarterly variability in testing rates, regression analyses revealed an average longitudinal increase of 3.58 per quarter in the ED and a 2.6 quarter increase in primary care. Over the course of five years, we determined that the cost of HIV testing in primary care is estimated about $5,200 to $5,800, with a gradual increase in quarters 5 – 8.  We conclude that the implementation of HIV testing in primary care and ED is a cost effective approach to identifying patients with HIV. Over the course of this implementation, Veterans Health Administration (VHA) policy transitioned from written to verbal consent for HIV testing, serving to reduce the time, and cost(s) associated with the testing process.

Learning Areas:

Implementation of health education strategies, interventions and programs

Learning Objectives:
Demonstrate cost analysis model to assess the financial impact of rapid HIV testing in primary care and emergency department. Evaluate different health promotion program to increase HIV testing Analyze the sustainability of HIV testing programs to the underserved population.

Keyword(s): HIV/AIDS, Economic Analysis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD and years of experience conducting research in the realm of HIV.I am conducted the cost analysis and co-wrote the paper.
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: 4137.0: HIV Testing Strategies