A Cost Analysis Of HIV Antibody Testing Some City In Anhui Province

BackgroundAt present, the wide use of HIV antibody screening reagents in practice are ELISA (Enzyme Linked Immunosorbent Assay] and RT (Rapid Test). The cost of HIV antibody testing is affected by the reagent price, especially, the imported reagent and domestic reagent prices vary greatly. So, how to select appropriate reagent at the different HIV antibody testing procedure can lower the cost of HIV antibody testing or reduce the cost of diagnosed one HIV positive case.HIV testing laboratories are mainly distributed in institutions of disease control and prevention and medical care institutions in China. According to the laboratory’s function, work category and scope, HIV testing laboratories are categoried as HIV reference laboratory, HIV confirmed laboratory and HIV screening laboratory. According to the administrative division, HIV testing laboratory laboratories are classified as provincial, prefectural, county and town laboratories. Are the costs of HIV antibody test different with the different institutions, types and levels of HIV testing laboratory? What are the main influential factors of the cost of HIV antibody testing? For this purpose, we carried out this study.ObjectiveTo analyse the cost of the HIV antibody testing, distribution of cost, the cost of HIV antibody screening procedures and to figure out the cost of diagnosis of per HIV positive case and its influential factors.MethodsThe retrospective survey method was adopted to collect the basic and direct HIV antibody testing costs information of different HIV antibody screening procedures in different labs or sites between Jan1,2011and Jun30,2011in Fuyang city. The HIV antibody testing costs were divided into three parts, including the cost of testing reagent, manpower, training cost, transfer cost and laboratory-related cost. All data was input in EXCEL2010sheets. The costs of the HIV antibody testing, distribution of cost and the cost of HIV antibody screening procedures at different HIV antibody testing labs and to figure out the cost of diagnosis of per HIV positive case and its relative influential factors were analysed by descriptive tatistical methods and model fitting.ResultsThe cost of HIV antibody testing laboratory was composed of manpower cost, reagent cost and laboratory-related cost. Different AIDS testing laboratory detection of HIV antibodies to different cost structure. The composition of costs at different HIV antibody testing laboratory were different, which mainly influenced by the amount of detection sample.The average cost of per HIV positive case identified by present HIV antibody screening procedures was9,626RMB. Of them, the average cost per HIV positive case identified by institutions of CDC and medical institutions were3,585RMB and43,856RMB, respectively. The average cost per HIV positive case identified by the HIV antibody screening laboratory and the HIV antibody screening central laboratory were3,622RMB and3,548RMB, respectively. According to the different levels of HIV antibody testing insititutions, the average cost per HIV positive case identified by Yinquan District was52,257RMB, which was far higher than that of Fuyang city (8,548RMB) and Linquan County(5,778RMB). The direct HIV antibody testing reagent cost was affected by the testing sample size, the reagent price and the efficiency of reagent utilization in different HIV antibody testing process. The HIV antibody preliminary screening cost accounted for95%of the total testing cost.The mainly cost of HIV antibody detection was distributed in the preliminary screening process, which accounts to95%. The average preliminary screening cost was18.52RMB per case in HIV antibody preliminary screening laboratory, which is lower than the cost of antibody preliminary screening in hospital that is 50RMB per case. If the daily amount of HIV antibody testing was less than15samples, the use of RT screening detection in HIV screening laboratories was accord with economics cost requirements.The cost of diagnosis of per HIV positive case were maybe affected by HIV prevalence, the amounts of testing, the price of reagent, utilization efficiency of the reagent, population characteristics of testing and testing policy. The prices of domestic reagents were lower than the prices of imported reagent according to this survey and Using the8x12form of the ELISA kit can improve utilization efficiency of the reagent.ConclusionThe cost of HIV antibody testing laboratory was composed of manpower cost, reagent cost and laboratory-related cost. The average cost of per HIV positive case identified by present HIV antibody screening procedures was9,626RMB. The composition of costs at different HIV antibody testing laboratory were different, which mainly influenced by the amount of detection sample. The cost of diagnosis of per HIV positive case were mainly affected by HIV prevalence, the amounts of testing, the price of reagent, utilization efficiency of the reagent, population of testing and testing policy. The use of RT screening detection in HIV screening laboratories was accord with economics cost requirements when the daily amount of HIV antibody testing was less than15samples,. Using the8x12form of the ELISA kit can improve utilization efficiency of the reagent, thereby reducing the cost of reagent.