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López Seguí F, Estrada Cuxart O, Mitjà i Villar O, Hernández Guillamet G, Prat Gil N, Maria Bonet J, Isnard Blanchar M, Moreno Millan N, Blanco I, Vilar Capella M, Català Sabaté M, Aran Solé A, Argimon Pallàs JM, Clotet B, Ara del Rey J. A Cost-Benefit Analysis of the COVID-19 Asymptomatic Mass Testing Strategy in the North Metropolitan Area of Barcelona. Int J Environ Res Public Health 2021; 18:7028. [PMID: 34209328 PMCID: PMC8297108 DOI: 10.3390/ijerph18137028] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. OBJECTIVE To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. METHODOLOGY Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. RESULTS Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. CONCLUSION Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.
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Affiliation(s)
- Francesc López Seguí
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority Catalan Institute of Health, 08916 Badalona, Spain;
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain;
- Centre de Recerca en Economía de la Salut, Pompeu Fabra University, 08005 Barcelona, Spain;
| | - Oriol Estrada Cuxart
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority Catalan Institute of Health, 08916 Badalona, Spain;
| | | | | | - Núria Prat Gil
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Josep Maria Bonet
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Mar Isnard Blanchar
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Nemesio Moreno Millan
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Ignacio Blanco
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Marc Vilar Capella
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Martí Català Sabaté
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Anna Aran Solé
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | | | - Bonaventura Clotet
- IrsiCaixa—Institut de Recerca de La SIDA, Hospital Universitari Germans Trias I Pujol, 08916 Badalona, Spain;
| | - Jordi Ara del Rey
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
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