Anti-rabies treatments in New Mexico: impact of a comprehensive consultation-biologics system.

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Abstract
Fewer than 20% of the 30,000 anti-rabies treatments administered in the United States each year are necessary. New Mexico established a comprehensive consultation-biologics program to assist physicians in making appropriate and systematic rabies treatment decisions. In 1978, 32 individuals received anti-rabies treatments as the result of 144 physician consultation requests. Dog and cat exposures accounted for 70 per cent of consultations and 63 per cent of the treatments. A seasonal peak of both consultations and treatments was observed in the summer and early autumn. The cost of biologics was $212 per treatment. Coordinated use of laboratory diagnostic services and animal control resources obviated the need for treatment in over 60 per cent of the 112 consultations not resulting in treatment. Experience in 1978 suggested that the system was probably responsible for a greater than five-fold reduction in the annual rate of anti-rabies treatments in New Mexico. Efficient physician utilization and high acceptability of the program may be attributed to maximization of private sector input into design and implementation of this public health program.