TABLE 5. Scenario Results for a Hypothetical Cohort of 100,000 Male Inmates*.
| Measure | Scenarios
|
||||
|---|---|---|---|---|---|
| 1: Symptom-Based Testing (Baseline)† | 2: Screen All During PE Day†,‡ | 3: Screen All ≤35 y of Age During PE†,‡ | 4: Screen All on Days 2–3 of Entry to Jail† | 5: Screen All ≤35 y of Age on Days 2–3 of Entry to Jail† | |
| No. male inmates infected at time of entry to jail§ | 10,313 (10,109–10,548) | 10,344 (10,170–10,566) | 10,358 (10,135–10,523) | 10,322 (10,096–10,501) | 10,354 (10,144–10,604) |
| No. uninfected male inmates screened | — | 21,505 (21,228–21,683) | 12,694 (12,557–12,857) | 34,544 (34,261–34,803) | 20,415 (20,221–20,557) |
| No. infected male inmates tested and treated while in jail¶ | 2149 (2061–2250) | 2607 (2560–2693) | 2572 (2464–2625) | 3186 (3086–3270) | 3108 (3039–3162) |
| No. male inmates infected at time of release from jail | |||||
| Number not tested | 8021 (7878–8167) | 6926 (6823–7052) | 7051 (6920–7195) | 5728 (5628–5825) | 5968 (5820–6138) |
| Number tested but not received results¶ | 143 (95–190) | 811 (753–858) | 735 (668–787) | 1408 (1359–1458) | 1278 (1209–1331) |
| No. women infected from transmissions | 6087 (5974–6249) | 5531 (5439–5647) | 5597 (5462–5727) | 4988 (4911–5086) | 5092 (4971–5239) |
| Infections averted in women | Baseline | 556 | 491 | 1099 | 995 |
| Total cost of scenario|| | 114,961 (110,804–119,751) | 802,539 (794,885–811,409) | 535,925 (530,244–541,231) | 1,249,464 (1,240,422–1,258,696) | 819,738 (812,319–826,155) |
| Cost breakdown by type and payer (% of total cost)** | |||||
| Testing costs—CHS | 36% | 56% | 54% | 57% | 55% |
| Testing costs—MCDPH | 23% | 35% | 34% | 35% | 34% |
| Treatment costs—CHS | 14% | 3% | 4% | 2% | 3% |
| Treatment costs—MCDPH | 27% | 5% | 8% | 5% | 7% |
| Incremental cost per infection averted in women compared with baseline | Baseline | 1237 | 858 | 1032 | 709 |
Means and 95% confidence intervals of the variables were calculated by running the simulation 30 times each with 100,000 male inmates. There were approximately 100,000 male inmates entering Maricopa county jails each year.
Under each scenario, an inmate was randomly assigned a test day, that is, a random day between 8 and 14 under scenarios 2 and 3 and a random day between 2 and 3 under scenarios 4 and 5. Symptomatic persons who show symptoms before test day would seek medical help within a day of showing symptoms. An inmate would be eligible for testing while in jail only if his release from jail is any day after his assigned test day or, in symptomatic cases, any day after day of showing symptoms.
PE was conducted on days 8 to 14 from the time of entry to jail.
The model is stochastic; that is, the outcome of events such as the infection status of a person is determined by drawing random numbers from a distribution, and therefore, there are variations in results across runs. The overlap of confidence intervals across the scenarios indicates that the number of infected inmates is not statistically different across scenarios.
Infected inmates who were tested because of symptoms or screening program.
Costs incurred by CHS and MCDPH only. All costs are in 2011 US dollars.
Test costs are for screening or testing inmates in jail, which is paid by both CHS and MCDPH, as indicated in Table 3. If an inmate is in jail at the time of treatment, all treatment costs are incurred by CHS. If an inmate has left the jail, all treatment costs including finding inmate are incurred by MCDPH.