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The cost of Medicaid savings: the potential detrimental public health impact of neonatal circumcision defunding.
Infect Dis Obstet Gynecol. 2012; 2012:540295.ID

Abstract

OBJECTIVE

To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state.

METHODS

Using 2009 South Carolina (SC) Medicaid birth cohort (n = 29, 316), we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases.

RESULTS

Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000.

CONCLUSIONS

For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

Authors+Show Affiliations

Department of Pediatrics, Medical University of South Carolina, 135 Rutledge Avenue, P.O. Box 250561, Charleston, SC 29425, USA. andrewsan@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23125519

Citation

Andrews, Annie L., et al. "The Cost of Medicaid Savings: the Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding." Infectious Diseases in Obstetrics and Gynecology, vol. 2012, 2012, p. 540295.
Andrews AL, Lazenby GB, Unal ER, et al. The cost of Medicaid savings: the potential detrimental public health impact of neonatal circumcision defunding. Infect Dis Obstet Gynecol. 2012;2012:540295.
Andrews, A. L., Lazenby, G. B., Unal, E. R., & Simpson, K. N. (2012). The cost of Medicaid savings: the potential detrimental public health impact of neonatal circumcision defunding. Infectious Diseases in Obstetrics and Gynecology, 2012, 540295. https://doi.org/10.1155/2012/540295
Andrews AL, et al. The Cost of Medicaid Savings: the Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding. Infect Dis Obstet Gynecol. 2012;2012:540295. PubMed PMID: 23125519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cost of Medicaid savings: the potential detrimental public health impact of neonatal circumcision defunding. AU - Andrews,Annie L, AU - Lazenby,Gweneth B, AU - Unal,Elizabeth Ramsey, AU - Simpson,Kit N, Y1 - 2012/10/18/ PY - 2012/08/08/received PY - 2012/09/13/accepted PY - 2012/11/6/entrez PY - 2012/11/6/pubmed PY - 2013/4/5/medline SP - 540295 EP - 540295 JF - Infectious diseases in obstetrics and gynecology JO - Infect Dis Obstet Gynecol VL - 2012 N2 - OBJECTIVE: To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. METHODS: Using 2009 South Carolina (SC) Medicaid birth cohort (n = 29, 316), we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. RESULTS: Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. CONCLUSIONS: For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs. SN - 1098-0997 UR - https://www.unboundmedicine.com/medline/citation/23125519/The_cost_of_Medicaid_savings:_the_potential_detrimental_public_health_impact_of_neonatal_circumcision_defunding_ L2 - https://doi.org/10.1155/2012/540295 DB - PRIME DP - Unbound Medicine ER -