Sexually transmitted diseases (STD) continue to be a major health problem in the U.S. Despite the persistence of STDs and the critical role of the public health sector in controlling these diseases, STD services continue to be reduced. A linear regression was performed using county demographic and cost variables. Many of these variables in county public health agencies and the populations they serve were not significantly correlated with cost of service. However, the availability of local tax funding for county health departments (CHDs), which varies extensively across counties within the state, is statistically linked to higher STD expenditure per case. County STD rates were also negatively correlated with cost of service. As the STD rate increases, the cost per STD case decreases implying some economies of scale. County population size did not have any effect on the cost per case. Understanding the factors contributing to the unit costs of STD services is critical to be able to make actionable and prudent decisions about continued financial support for public health agency based STD prevention/control services.
Livingood WC, Bilello L, Sorensen B. Understanding cost variations in STD service delivery as state and federal agencies reduce funding. Front Public Health Serv Syst Res