[Cost analysis of toxoplasma infection control in pregnancy]

In Italy, the management of Toxoplasma infection screening in pregnant women is often unproductive and inefficient and generates a wide variability of costs. This study evaluated performance parameters in the screening management of a population of pregnant women, estimated its costs and compared them with the costs of a full application of Ministerial Documents of 1995 and 1998. We controlled until delivery 830 pregnant women who had done the first blood test between September 1st and December 31st 1997. The costs of direct and indirect testing were analysed using the Excel database and statistical software package. Of the 573 pregnant women defined 'susceptible' at the first test, only 240 (42%) did further blood tests during the II and III trimesters, 30% did no more tests and the remaining women adopted a heterogeneous behaviour. The mean cost of each screening was found to be euro 54.47/pregnancy and euro 60.05/pregnancy with a full application of the Ministerial Document of 1995. A full application of Ministerial Document of 1998, instead, would have involved a cost of euro 94.28/pregnancy for 5 tests, euro 111.40/pregnancy for 6 tests and euro 128.51 for 7 tests. The study shows that the management of toxoplasmosis screening during pregnancy needs greater attention to the prescription of tests, so that useless testing can be reduced and the efficacy of the screening improved, two important goals the Ministerial Documents were designed to achieve.