Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Richard Ingram

Committee Member

Maureen Jones

Committee Member

Martha Riddell


Rabies, though rare in the United States, remains a lethal viral disease with significant public health implications. Post-exposure prophylaxis (PEP) through timely administration of rabies vaccines and rabies immune globulin (RIG) is critical for preventing the progression of the virus following potential exposure. However, the current system of healthcare delivery in the United States has witnessed an alarming trend: the unnecessary utilization of emergency department (ED) visits for rabies PEP, including follow-up vaccinations. This paper aims to examine and address this issue through a review of the factors contributing to the inappropriate use of ED services for rabies treatment.

Through a review of existing literature, this paper highlights the complexities surrounding rabies PEP, including accessibility to vaccination clinics, patient education, and healthcare policy implications. The misuse of ED resources for rabies PEP not only strains healthcare infrastructure but also leads to inefficiencies in patient care and increased healthcare costs. By understanding the underlying issues, healthcare providers and policymakers can implement targeted interventions to redirect patients to more appropriate and cost-effective care settings.

By redefining the standard of rabies PEP delivery, healthcare systems can optimize resource allocation, improve patient outcomes, and mitigate the burden on EDs in the Commonwealth.

This review highlights the substantial potential for cost reduction associated with optimizing rabies PEP. A modest decrease of 27% in emergency department visits would effectively address the cost burden of medication provision at secondary rabies care centers. Reducing the current number of return visits to the ED for the follow-up vaccination series by 50% could result in the state healthcare system saving over $1 million. The ancillary benefits, such as reduced ED wait times leading to reduced mortality rates, hold promise for additional cost-saving advantages for the Commonwealth.

This paper reiterates the importance of continued reevaluation of healthcare utilization patterns and advocates for a paradigm shift towards more efficient and patient-centered care delivery models. By addressing the root causes of unnecessary ED visits for rabies treatment, stakeholders can work towards enhancing the accessibility, affordability, and effectiveness of rabies PEP while ensuring the prudent use of healthcare resources.

Available for download on Friday, August 09, 2024

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