caa a22 4500 397577451 CHVBK 20180308164859.0 cr unu---uuuuu 161202e199612 xx s 000 0 eng 10.1093/oxfordjournals.pubmed.a024539 doi (NATIONALLICENCE)oxford-10.1093/oxfordjournals.pubmed.a024539 The costs and effectiveness of surveillance of communicable disease: a case study of HIV and AIDS in England and Wales [Elektronische Daten] [Stephen Morris, Alastair Gray, Ahilya Noone, Meg Wiseman, Sushil Jathanna] Background In England and Wales, surveillance of communicable disease is carried out and co-ordinated by the Public Health Laboratory Service (PHLS). The surveillance of HIV infection and AIDS is undertaken by the PHLS AIDS Centre at the Communicable Disease Surveillance Centre(CDSC). Epidemiological data derived from surveillanceare not, however, a free good: they are a resource with an associated opportunity cost and should therefore be open to economic appraisal along side other uses of healthcare resources such as medical interventions. This paper assembles information on the current surveillance of HIV and AIDS in England and Wales, and explores methods for performing an economic evaluation of such activities. Methods An examination of the cost and effectiveness of the PHLS AIDS Centre's epidemiological surveillance mechanisms for HIV and AIDS in England and Wales was undertaken. The total costs of each component of surveillance of HIV and AIDS in England and Wales were calculated. Two categories of cost were estimated: peripheral costs incurred by reporters in reporting AIDS cases or HIV infections or by laboratories in collecting samples; and central costs incurred by the PHLS AIDS Centre in processing and analysing incoming data. Using these cost data and information from a cost-effectiveness register, the additional health gains that would have to be obtained from surveillance to make the programme broadly cost-effective in comparison with other accepted uses of health service resources were then estimated. Results In the financial year 1993-1994 the total costs of surveillance were estimated to be £1⋅4 million. To avoid being considered relatively cost-ineffective at least 3⋅5 infections per annum need to be averted. To be considered favourably cost-effective, approximately 9⋅5 infections perannum need to be averted. Conclusions In 1993-1994, expenditure on surveillance of HIV and AIDS accounted for less than 1 per cent of the total allocation of resources to the National Health Service for all HIV and AIDS activities. Given these cost estimates, the number of infections which surveillance would have to contribute towards preventing in order to be considered cost-effective is low. © Oxford University Press Articles nationallicence surveillance nationallicence HIV-AIDS nationallicence cost nationallicence information nationallicence Morris Stephen City University Northampton Square, London EC1V 0HB, UK aut Gray Alastair Centre for Socio-Legal Studies, Wolfson College Oxford OX2 6UD, UK aut Noone Ahilya Public Health Laboratory Service 61 Colindale Avenue, London NW9 5EQ, UK aut Wiseman Meg Public Health Laboratory Service 61 Colindale Avenue, London NW9 5EQ, UK aut Jathanna Sushil Department of Public Health, North Essex Health Authority Turner Road, Colchester, Essex CO4 5JR, UK aut Journal of Public Health Oxford University Press 18/4(1996-12), 415-422 1741-3842 18:4<415 1996 18 pubmed https://doi.org/10.1093/oxfordjournals.pubmed.a024539 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/oxfordjournals.pubmed.a024539 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morris Stephen City University Northampton Square, London EC1V 0HB, UK aut NATIONALLICENCE 700 1- Gray Alastair Centre for Socio-Legal Studies, Wolfson College Oxford OX2 6UD, UK aut NATIONALLICENCE 700 1- Noone Ahilya Public Health Laboratory Service 61 Colindale Avenue, London NW9 5EQ, UK aut NATIONALLICENCE 700 1- Wiseman Meg Public Health Laboratory Service 61 Colindale Avenue, London NW9 5EQ, UK aut NATIONALLICENCE 700 1- Jathanna Sushil Department of Public Health, North Essex Health Authority Turner Road, Colchester, Essex CO4 5JR, UK aut NATIONALLICENCE 773 0- Journal of Public Health Oxford University Press 18/4(1996-12), 415-422 1741-3842 18:4<415 1996 18 pubmed Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford