A cost-based decision analysis for Chlamydia screening in California family planning clinics

Obstet Gynecol. 1988 Jan;71(1):101-8.


Antibody-based methods for the diagnosis of Chlamydia trachomatis infection of the cervix have recently made population screening programs possible for this epidemic and frequently asymptomatic problem. We constructed a decision model, using medical care costs as utilities, to determine the total costs of screening and of not screening in California state-funded family planning clinics, and to determine the prevalence of infection at which such screening could be expected to pay for itself. A net savings of $6 million would be realized in the first year, with annual savings eventually increasing to over $13 million, from the prevention of chlamydia-associated pelvic inflammatory disease and other long-term sequelae such as tubal infertility and ectopic pregnancy. Over $60 million could be saved in the first five years of such a statewide screening program. In populations with infection prevalence of 2% or more, such screening will pay for itself and can be considered "cost-effective." Screening of asymptomatic women for chlamydia should be carried out in most American family planning clinics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlamydia Infections / complications
  • Chlamydia Infections / economics
  • Chlamydia Infections / prevention & control*
  • Community Health Services / economics*
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Decision Trees
  • Family Planning Services
  • Female
  • Humans
  • Male
  • Mass Screening / economics*
  • Sexually Transmitted Diseases / complications
  • Sexually Transmitted Diseases / economics
  • Sexually Transmitted Diseases / prevention & control*