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Volume 24, Number 10—October 2018
Research

Tuberculosis Treatment Monitoring by Video Directly Observed Therapy in 5 Health Districts, California, USA

Richard S. GarfeinComments to Author , Lin Liu, Jazmine Cuevas-Mota, Kelly Collins, Fatima Muñoz, Donald G. Catanzaro, Kathleen Moser, Julie Higashi, Teeb Al-Samarrai, Paula Kriner, Julie Vaishampayan, Javier Cepeda, Michelle A. Bulterys, Natasha K. Martin, Phillip Rios, and Fredric Raab
Author affiliations: University of California San Diego, La Jolla, California, USA (R.S. Garfein, L. Liu, J. Cuevas-Mota, K. Collins, F. Muñoz, J. Cepeda, M.A. Bulterys, N.K. Martin, P. Rios, F. Raab); University of Arkansas, Fayetteville, Arkansas, USA (D.G. Catanzaro); San Diego County Health and Human Services Agency, San Diego, California, USA (K. Moser); San Francisco Department of Public Health, San Francisco, California, USA (J. Higashi); Santa Clara County Public Health Department, San Jose, California, USA (T. Al-Samarrai); Imperial County Public Health Department, El Centro, California, USA (P. Kriner); San Joaquin Public Health Services, Stockton, California, USA (J. Vaishampayan)

Main Article

Table 5

Average in-person DOT and VDOT costs per treatment course, by site, based on standard drug-susceptible tuberculosis treatment regimen consisting of 56 intensive-phase and 126 continuation-phase doses, 4 California health districts, 2015–2016*

Characteristic
San Diego
San Francisco
San Joaquin
Imperial
In-person DOT costs
Personnel
Administrative tasks 1,038 3,043 1,913 842
In-person patient contact 1,207 622 2,223 656
Travel 1,939 1,065 702 1,293
Total personnel (% of total) 4,185 (91) 4,729 (97) 4,838 (84) 2,791 (87)
Mileage (% of total) 364 (9) 158 (3) 950 (16) 421 (13)
Grand total
4,549
4,888
5,788
3,212
VDOT costs
Personnel
Administrative tasks 796 1,922 1,771 1,183
In-person patient contact 671 291 393 346
Watching videos 80 131 152 473
Other, e.g., training and follow-up 869 933 156 348
Total personnel (% of total) 2,526 (79) 3,277 (88) 2,472 (83) 2,350 (78)
Mileage (% of total) 20 (1) 0 31 (1) 46 (2)
Smartphone costs, device and service (% of total) 424 (13) 424 (7) 424 (8) 424 (14)
VDOT application service fee, $35/mo/patient (% of total) 210 (7) 210 (5) 210 (7) 210 (7)
Grand total
3,179
3,911
3,137
3,031
% Change for VDOT versus in-person DOT
Personnel costs, % −40 −31 −49 −16
Overall costs, % −30 −20 −46 −6

*All values are USD unless otherwise indicated. Comparable data could not be obtained from the Santa Clara site because of staff turnover. DOT, directly observed therapy; VDOT, video directly observed therapy.

Main Article

Page created: September 16, 2018
Page updated: September 16, 2018
Page reviewed: September 16, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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