Current Under Proposed

Extra
Status Intervention
Dollars
(Symptomatic STD (Asymptomatic STD
Saved
Screening and Screening and
(Benefits)
Treatment) Treatment)
Costs Associated with
Sexually Transmitted
Diseases
Number of Patients with
STI Screening1 1260 8400
1260*$31.68 = 8400*$31.68 =
Cost per STD Screening2
$39,916.80 $266,112.00
Number of Patients with
Positive STD Screening 1008 1260
Results 3, 4
Percent of Patients with
Positive STI Screening 80% 80%
Receiving Treatment 5
Number of Patients
806 1008
Treated 4, 5
806*$27.68 = 1008*$27.68 =
Cost per STD Treatment
$22,310.08 $27,901.44
Sequelae costs averted by
treatment of people with 80 PID cases averted * 100 PID cases
chlamydia, gonorrhea, and $1995 averted*$1995 $39,900
syphilis 7, 8, 9, 10 = $159,600 = $199,500

2 Epididymitis cases
1 Epididymitis case
averted * $274
averted*$274 = $274 $274
= $548
2
Neurovascular/Cardio
Neurovascular/Cardiovasc
vascular Syphilis case
ular Syphilis case averted
averted * $572 = $572
* $572 = $1144
604 females treated *
$315 transmission 806 females treated * $315
Treatment and sequelae
averted cost = transmission averted cost =
costs averted by reducing $63, 630
$190,260 $253, 890
transmission of chlamydia,
gonorrhea, and syphilis 8, 9,
10, 11 202 males treated * 252 males treated * $26
$26 transmission transmission averted cost =
averted cost = $6,552.00
$1300
$5,252.00
 604 females treated *
806 females treated * $343
$343 transmission
transmission averted cost =
averted cost = $69,286
$276, 458
$207,172

202 males treated * $

252 males treated * $ 68
68 transmission
transmission averted cost =
averted cost = $13, $3400
$17, 136.00
736.00

1 cases treated * 2 cases treated * $572.00

$572.00 transmission transmission averted cost =
$572
averted cost = $572.00 $1144.00
Total Extra Dollars Saved $ 178, 362

Total Costs $62,226.88 $294,013.44

Expected Reimbursement
$49781.50 $235,210.75
(80%) 12
(Extra
Dollars
Spent for
More
Net costs: $12, 445.38 Net costs: $58, 802.69
Screening
and
Treatment)
$46,357.31
$178, 362 -
$46,357.31
Net Savings
=
$132,004.69

Direct Program Costs

RN Training 13 $825.75
MD/NP/PA Training 14 $1, 995
Patient Education
$2,392.78
Materials 15
Administrative Costs 16 $21, 195.01
Total Program Costs $26, 408.54

Net Savings ($132,004.69) / Total

Cost- Benefit ratio Program Costs ($26,408.54) = 4.99

Therefore, for every dollar spent in the new program, $ 4.99 is saved.
1 - Estimate based on RUMCs 70,000 ED visits in 2015. Under proposed intervention, 15% are
meeting inclusion criteria for STD screening (age/sexual behavior/pregnancy status) and 80%
consenting to do STD screening. Current status is estimated based on US Survey (Hollander,
2016) that only 12% of the adolescents and young adult have had an STD screening due to
having symptoms

2- Silva et al (2007) states the STD Test costs in a similar study as $27.37 per person. Screening
costs is adjusted for 2017-dollar value at $31.68 at 15.38% inflation rate

3- Under the proposed intervention, an estimate of 15% of asymptomatic STD positive screening
in the ED setting is assumed as provided on literature review from by Schneider, Fitzgerald,
Byczkowski, & Reed (2016).

4 Patients who present to ED with STD symptoms are empirically treated (approximately
80%).

5 - An estimate of 20% will not receive treatment due to patients decision or for other instances
such as when provider is unable to reach patient on follow-up calls (Schneider, Fitzgerald,
Byczkowski, & Reed (2016).)

6 - Silva et al (2007) states the STD Treatment costs in a similar study as $23.91 per person.
Treatment costs is adjusted for 2017-dollar value at $27.68 at 15.80% inflation rate.

7 Sequelae costs averted by treatment of people with chlamydia, gonorrhea, and syphilis:
Chesson et al. (2008) estimates $1,995 as the direct medical cost per case of Pelvic Inflammatory
Disease, $572 direct medical cost for possibility of neurosyphilis and cardiovascular syphilis in
untreated syphilis cases and $274 as the direct medical cost per case of epididymitis.

8 - Symptomatic PID occurs in about 10 to 15 percent of women with untreated chlamydia

(CDC, 2016)

9 - CDC (2016) reports there is approximately 1 male infected with STD for every 3 females
infected in 15-24 age group;1 man out of every 144 men (0.69 percent) in US is affected with
Epididymitis related to STDs

10 - In Cook County, IL the syphilis infection rate is 17.4 per 100,000 (CDC, 2016)

11 - Treatment and sequelae costs averted by reducing transmission of chlamydia, gonorrhea,

and syphilis. Chesson et al. (2008) estimates these costs as follows: $315 and $26 for chlamydia
in women and men, respectively; $343 and $68 for gonorrhea in women and men, respectively,
and $572 for syphilis in men and women.

12 HealthCare.Gov (2016) states that a common reimbursement percentage is 80%.

13 - Per glassdoor.com, Rush RN average salary is $33.03. If 30 minutes is spent on training
nurses to implement this program, training 50 nurses in the ED would cost $825.75

14 - According to beckershospitalreview.com, emergency medicine providers earn an average of

$133 hourly. If 30 minutes is spent on training ED providers to implement this program, training
30 providers in the ED would cost $1, 995.

15 - Silva et al (2007) estimates patient education materials costs at $2000 which was adjusted to
2017-dollar value of $2,392.78 at 1.81% inflation.

16 Silva et al (2007) In their similar study estimates $17,716 as administrative costs (obtaining
informed consent, delivering positive test results, and referring patients for treatment. This
amount is adjusted to 2017-dollar value of 21, 195.29 at 1.81% inflation.