STANFORD, Calif--Screening surgeons for HIV to protect their patients
would not be cost effective, compared to the cost of most accepted
health-care interventions, says Dr. Douglas Owens, professor of
health research and policy, Stanford University School of Medicine.
The finding calls into question proposals made by policy makers
and others to require US health-care workers to be screened for
HIV, says Dr. Owens, who led the study. Such proposals would generally
bar those found to be infected from performing procedures that
might expose patients to the virus.
The researchers analyzed a variety of data from the literature
to assess the benefits and costs of such screening. The results
showed that a one-time national screening program would find about
137 infected surgeons and prevent between 1.9 and 21.3 infections
in their patients during the remainder of their surgical careers.
The intervention would also prevent approximately 0.9 infections
in the surgeons' sexual partners (Annals of Internal Medicine,
May 1, 1995).
The cost of these benefits would be at least $8.1 million, or
$458,000 per year of life saved. Dr. Owens notes, however, that
health interventions considered to be cost effective usually cost
between $10,000 and $100,000 per year of life saved.
"The message is that the risk of getting HIV from a surgeon
is extremely remote and that screening surgeons to prevent such
an unlikely event is not a wise use of public resources,"
Dr. Owens' colleagues in the study were Robert Nease, assistant
professor of medicine, Washington University, and Stanford researchers
Ryan Harris and Patricia Scott. Ms. Scott is now a medical student
at Georgetown University.