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Psychiatr Serv. 2013 Feb 1;64(2):127-33. doi: 10.1176/appi.ps.000852011.

Costs of a public health model to increase receipt of hepatitis-related services for persons with mental illness.

Author information

1
Veterans Affairs CapitolHealth Care Network (Veterans Integrated Service Network), Mental Illness Research, Education and Clinical Center, Baltimore, MD, USA. eslade@psych.umaryland.edu

Abstract

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.

PMID:
23475451
PMCID:
PMC3637942
DOI:
10.1176/appi.ps.000852011
[Indexed for MEDLINE]
Free PMC Article

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