Letter to editor: Toward a positive contribution to understanding cost-effectiveness issues in the surveillance and prevention of occupational disease.
Geidenberger-CA; Nestel-G; Socie-EM
Am J Ind Med 1999 Apr; 35(4):432-433
We appreciate Rosenman's interest in our study on the cost-effectiveness of hospital discharge records for the surveillance of silicosis [Geidenberger et al., 1998a]. Rosenman raises several concerns about potential biases and interpretations of our study results. We address these here. Our goal in conducting this research was to identify inefficiencies in Ohio's surveillance system, so that improvements in cost-effectiveness of the program might be made. By comparing average costs of each data source relative to the others, we identified two major areas of inefficiency: 1) low output / high average cost of obtaining case names from physician reports, and 2) low output / high average cost of identifying work sites with ongoing silica problems from cases identified through hospital discharge records. From Rosenman's 1999 letter, one might conclude that we therefore advocated abandonment of all data sources other than physician reports for silicosis surveillance and prevention.
Disease-prevention; Occupational-diseases; Surveillance-programs; Silicosis; Health-care-facilities; Information-systems; Case-studies; Physicians
National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226-1998
American Journal of Industrial Medicine