19. Cost-Effectiveness of the Technology-Enhanced Community Health Nursing Intervention for Adolescents and Young Adults with Pelvic Inflammatory Disease

Pelvic inflammatory Disease (PID) disproportionately impacts adolescent and young adult women with the risk of major reproductive health sequelae. The Technology-Enhanced Community Health Nursing (TECH-N) trial demonstrated potential benefit a novel community nursing intervention for female adolescents PID in an urban setting. In this study, we assess cost-effectiveness such compared to standard care. We constructed cohort Markov model TECH-N captures nine states, including PID, two states STIs (Chlamydia trachomatis Neisseria gonorrhoeae), four sequelae (infertility, chronic pelvic pain, tubo-ovarian abscess, ectopic pregnancy), recovery state, death state. consisted hypothetical 18-year-old mild moderate starting Most transition probabilities between were derived from clinical published literature. state utilities Intervention costs estimated using data, Cost-effectiveness was assessed over 20-year time horizon system perspective. Multivariate probabilistic sensitivity analysis univariate used uncertainty. key outcome calculation incremental cost per quality-adjusted life year (QALY) group care group. Over course 20 years, generated 15.2 QALYs individual at $7,724. 14.7 $5,243. resulting ICER $4,960 QALY is well below willingness pay threshold $100,000 QALY. For arm, increased attributable program. Part offset by lower incidence, which typically contributes significant healthcare burden. higher driven incidence after initial occurrence PID. Sensitivity identified relative rate future be main drivers results. Our suggests cost-effective public that yields better outcomes slightly costs. addition, nature lends itself coupled other home-health /community engagement strategies, should reduce operating further improve its value proposition.