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Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to describe the importance and cost effectiveness of HBsAg confirmatory testing for perinatal hepatitis B case management.
Background:
Cases of HBsAg positive pregnant women are reported to Perinatal Hepatitis B staff for follow-up. From 2000- 2003, numerous cases were reported in women who did not appear to have either a risk factor or history of hepatitis B. A brief phone survey of laboratories showed that two laboratories were not performing confirmatory testing. Pathologists at the hospital laboratory were reluctant to change their protocol. However follow-up of a false- positive HBsAg case is extremely costly to both the hospital and the state's Perinatal Hepatitis B staff.
Methods:
The cost of HBsAg confirmatory testing was determined by surveying local laboratories. A list of case management tasks was compiled with a range of time spent on each activity. An approximate cost was assigned to the total time for case management. This amount along with estimated costs of testing and vaccine were compared to the cost of confirmatory testing.
Results:
Between 03/00 and 02/05, there were 63 cases of positive HBsAg pregnant women statewide which were later determined to be false positive, of those 63, 40 (63%) were from one facility. It was determined that the average cost of confirmatory testing in our area is $26. The estimated cost associated with follow-up of cases later determined to HBsAg negative ranged from $142- $308 with vaccination and testing costs exceeding $200.
Conclusions:
The cost and time spent on case management of false-positive HBsAg EIA's far outweighs the cost of HBsAg confirmatory testing. In addition, there are also psychological and social costs to the patient, which are more difficult to quantify.
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See more of The 2005 National Viral Hepatitis Prevention Conference