OBJECTIVE: This study examined the costs and impact on receipt of hepatitis and HIV testing and hepatitis immunization services of a public health intervention model that was designed for use by persons with serious mental illness and co-occurring substance use disorders. METHODS:Between 2006 and 2008, a random sample of 202 nonelderly, predominantly African-American males with a psychotic or major depressive disorder and a co-occurring substance use disorder was recruited at four community mental health outpatient programs in a large metropolitan area. Participants were randomly assigned at each site to enhanced treatment as usual (N=97), including education about blood-borne diseases and referrals for testing and vaccinations, or to an experimental intervention (N=105) that provided on-site infectious disease education, screening of risk level, pretest counseling, testing for HIV and hepatitis B and C, vaccination for hepatitis A and B, and personalized risk-reduction counseling. The authors compared the two study groups to assess the average costs of improving hepatitis and HIV testing and hepatitis A and B vaccination in this population. RESULTS: The average cost per participant was $423 for the intervention and $24 for the comparison condition (t=52.7, df=201, p<.001). The costs per additional person tested was $706 for hepatitis C, $776 for hepatitis B, and $3,630 for HIV, and the cost per additional person vaccinated for hepatitis was $561. CONCLUSIONS: Delivery of hepatitis and HIV public health services to persons with serious mental illness in outpatient mental health settings can be as cost-effective as similar interventions for other at-risk populations.
RCT Entities:
OBJECTIVE: This study examined the costs and impact on receipt of hepatitis and HIV testing and hepatitis immunization services of a public health intervention model that was designed for use by persons with serious mental illness and co-occurring substance use disorders. METHODS: Between 2006 and 2008, a random sample of 202 nonelderly, predominantly African-American males with a psychotic or major depressive disorder and a co-occurring substance use disorder was recruited at four community mental health outpatient programs in a large metropolitan area. Participants were randomly assigned at each site to enhanced treatment as usual (N=97), including education about blood-borne diseases and referrals for testing and vaccinations, or to an experimental intervention (N=105) that provided on-site infectious disease education, screening of risk level, pretest counseling, testing for HIV and hepatitis B and C, vaccination for hepatitis A and B, and personalized risk-reduction counseling. The authors compared the two study groups to assess the average costs of improving hepatitis and HIV testing and hepatitis A and B vaccination in this population. RESULTS: The average cost per participant was $423 for the intervention and $24 for the comparison condition (t=52.7, df=201, p<.001). The costs per additional person tested was $706 for hepatitis C, $776 for hepatitis B, and $3,630 for HIV, and the cost per additional person vaccinated for hepatitis was $561. CONCLUSIONS: Delivery of hepatitis and HIV public health services to persons with serious mental illness in outpatient mental health settings can be as cost-effective as similar interventions for other at-risk populations.
Authors: Josiah D Rich; Catherine G Ching; Michelle A Lally; Melissa M Gaitanis; Beth Schwartzapfel; Anthony Charuvastra; Curt G Beckwith; Timothy P Flanigan Journal: Am J Med Date: 2003-03 Impact factor: 4.965
Authors: S D Rosenberg; L A Goodman; F C Osher; M S Swartz; S M Essock; M I Butterfield; N T Constantine; G L Wolford; M P Salyers Journal: Am J Public Health Date: 2001-01 Impact factor: 9.308
Authors: A David Paltiel; Milton C Weinstein; April D Kimmel; George R Seage; Elena Losina; Hong Zhang; Kenneth A Freedberg; Rochelle P Walensky Journal: N Engl J Med Date: 2005-02-10 Impact factor: 91.245
Authors: Stanley Rosenberg; Mary Brunette; Thomas Oxman; Bryan Marsh; Allen Dietrich; Kim Mueser; Robert Drake; Will Torrey; Robert Vidaver Journal: Psychiatr Serv Date: 2004-06 Impact factor: 3.084