Costs of implementing and maintaining a tuberculin skin test program in hospitals and health departments.

OBJECTIVE: To determine (1) the annual costs of implementing and maintaining tuberculin skin test (TST) programs at participating study sites, (2) the cost of the TST program per healthcare worker (HCW), and (3) the outcomes of the TST programs, including the proportion of HCWs with a documented TST conversion and the proportion who accepted and completed treatment for latent TB infection, before and after the implementation of staffTRAK-TB software (Centers for Disease Control and Prevention, Atlanta, GA). DESIGN: Cost analysis in which costs for salaries, training, supplies, radiography, and data analysis were collected for two 12-month periods (before and after the implementation of staffTRAK-TB). SETTING: Four hospitals (two university and two city) and two health departments (one small county and one big city). RESULTS: The annual cost of implementing and maintaining a TST program ranged from dollars 66,564 to dollars 332,728 for hospitals and dollars 92,886 to dollars 291,248 for health departments. The cost of the TST program per HCW ranged from dollars 41 to dollars 362 for hospitals and dollars 176 to dollars 264 for health departments. CONCLUSIONS: Costs associated with implementing and maintaining a TST program varied widely among the participating study sites, both before and after the implementation of staffTRAK-TB. Compliance with the TB infection control guidelines of the Centers for Disease Control and Prevention may require a substantial investment in personnel time, effort, and commitment.