HIV Screening of Surgeons Probably Not Cost Effective, Study Suggests

STANFORD, Calif--Screening surgeons for HIV to protect their patientswould not be cost effective, compared to the cost of most acceptedhealth-care interventions, says Dr. Douglas Owens, professor ofhealth research and policy, Stanford University School of Medicine.

The finding calls into question proposals made by policy makersand others to require US health-care workers to be screened forHIV, says Dr. Owens, who led the study. Such proposals would generallybar those found to be infected from performing procedures thatmight expose patients to the virus.

The researchers analyzed a variety of data from the literatureto assess the benefits and costs of such screening. The resultsshowed that a one-time national screening program would find about137 infected surgeons and prevent between 1.9 and 21.3 infectionsin their patients during the remainder of their surgical careers.The intervention would also prevent approximately 0.9 infectionsin 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, thathealth interventions considered to be cost effective usually costbetween $10,000 and $100,000 per year of life saved.

"The message is that the risk of getting HIV from a surgeonis extremely remote and that screening surgeons to prevent suchan unlikely event is not a wise use of public resources,"he says.

Dr. Owens' colleagues in the study were Robert Nease, assistantprofessor of medicine, Washington University, and Stanford researchersRyan Harris and Patricia Scott. Ms. Scott is now a medical studentat Georgetown University.