Cost-Effectiveness Analysis of Community Case Management of Childhood Diarrhea in Burundi

2021 ◽  
Vol 25 ◽  
pp. 157-164
Author(s):  
Fulgence Niyibitegeka ◽  
Arthorn Riewpaiboon ◽  
Sermsiri Sangroongruangsri
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Cost Effectiveness Analysis ◽  
Community Case Management ◽  
Childhood Diarrhea ◽  
Effectiveness Analysis

scholarly journals Promoting the integrated community case management of pneumonia in children under 5 years in Nigeria through the proprietary and patent medicine vendors: a cost-effectiveness analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Charles E. Okafor ◽  
Obinna I. Ekwunife ◽  
Sabina O. Nduaguba
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Severe Pneumonia ◽  
Cost Effectiveness Analysis ◽  
World Health ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Effectiveness Analysis ◽  
Patent Medicine ◽  
Children Under 5

Abstract Background While evidence-based recommendations for the management pneumonia in under-5-year-olds at the community level with amoxicillin dispersible tablets (DT) were made by the World Health Organisation, initiatives to promote the integrated community case management (iCCM) of pneumonia through the proprietary and patent medicine vendors (PPMVs) have been poorly utilized in Nigeria, possibly due to low financial support and perceived benefit. This study provides costs, benefits and cost-effectiveness estimates and implications of promoting the iCCM through the PPMVs’ education and support. The outcome of this study will help inform healthcare decisions in Nigeria. Methods This study was a cost-effectiveness analysis using a simulation-based Markov model. Two approaches were compared, the ‘no promotion’ and the ‘promotion’ scenarios. The health outcomes include disability-adjusted life years averted and severe pneumonia hospitalisation cost averted. The costs were expressed in 2019 US dollars. Results The promotion of iCCM through the PPMVs was very cost effective with an incremental cost-effectiveness ratio of US$143.77 (95% CI US$137.42–150.50)/DALY averted. The promotion will prevent 28,359 cases of severe pneumonia hospitalisation with an estimated healthcare cost of US$390,578. It will also avert 900 deaths in a year. Conclusion Promoting the iCCM for the treatment of pneumonia in children under 5 years through education and support of the PPMVs holds promise to harness the benefits of amoxicillin DT and provide a high return on investment. A nationwide promotion exercise should be considered especially in remote areas of the country.

Intensive Case Management: A Cost-Effectiveness Analysis

1998 ◽  
Vol 32 (4) ◽  
pp. 551-559 ◽  
Author(s):  
Susan Johnston ◽  
Glenn Salkeld ◽  
Kristy Sanderson ◽  
Catherine Issakidis ◽  
Maree Teesson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Health Services ◽  
Case Management ◽  
Cost Effectiveness Analysis ◽  
Additional Patient ◽  
Intensive Case Management ◽  
Management Group ◽  
Effectiveness Analysis ◽  
Clinically Significant

Objective: The objective of this study was to compare the outcomes and costs of intensive case management with routine case management for a group of severely disabled patients with a mental illness. Method: A cost-effectiveness analysis was conducted alongside a randomised con trolled trial. Seventy-three patients, who reside in the eastern suburbs of Sydney, were randomly allocated to either intensive or routine case management. Staff pro viding intensive case management had substantially lower caseloads than staff pro viding routine case management. The main health outcome measured was patients' level of functioning as measured by the Life Skills Profile. Costing data were collect ed from hospital services, mental health services, general health services, community services and informal carers. Results: At 12 months, outcome and costing data were analysed on 58 patients and hospitalisation data were analysed on 68 patients. Significantly more patients in the intensive case management group remained in treatment (χ2 = 6.00, df = 1, p < 0.01) and showed a clinically significant improvement in functioning from base line to 12 months (χ2 = 4.50, df = 1, p < 0.05). The mean cost per patient was $7745 more in the intensive group than in the routine group (t = 1.49, df = 56, p > 0.01) over 12 months. The cost-effectiveness ratio indicated a cost of $27 661 per year for one additional patient in the intensive case management group to make a clinically significant improvement in functioning. Conclusion: Intensive case management led to an increased rate of retention in treatment and a clinically significant improvement in functioning. Further comparative cost-effectiveness studies are required to determine whether $27 661 per year for one patient to make a clinically significant improvement in functioning is a cost-effective use of mental health resources.

Intensive case management: a cost- effectiveness analysis

1998 ◽  
Vol 32 (4) ◽  
pp. 551-559 ◽  
Author(s):  
Susan Johnston ◽  
Glenn Salkeld ◽  
Kristy Sanderson ◽  
Catherine Issakidis ◽  
Maree Teesson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Cost Effectiveness Analysis ◽  
Intensive Case Management ◽  
Effectiveness Analysis

scholarly journals Cost-effectiveness analysis of integrated community case management delivery models utilizing drug sellers and community health workers for treatment of under-five febrile cases of malaria, pneumonia, diarrhoea in rural Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Patrick Lubogo ◽  
John Edward Lukyamuzi ◽  
Deo Kyambadde ◽  
Alex Aboda Komakech ◽  
Freddy Eric Kitutu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Incremental Cost ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Effectiveness Analysis ◽  
Delivery Models ◽  
Drug Sellers ◽  
Drug Seller

Abstract Background Malaria, pneumonia and diarrhoea continue to be the leading causes of death in children under the age of five years (U5) in Uganda. To combat these febrile illnesses, integrated community case management (iCCM) delivery models utilizing community health workers (CHWs) or drug sellers have been implemented. The purpose of this study is to compare the cost-effectiveness of delivering iCCM interventions via drug sellers versus CHWs in rural Uganda. Methods This study was a cost-effectiveness analysis to compare the iCCM delivery model utilizing drug sellers against the model using CHWs. The effect measure was the number of appropriately treated U5 children, and data on effectiveness came from a quasi-experimental study in Southwestern Uganda and the inSCALE cross-sectional household survey in eight districts of mid-Western Uganda. The iCCM interventions were costed using the micro-costing (ingredients) approach, with costs expressed in US dollars. Cost and effect data were linked together using a decision tree model and analysed using the Amua modelling software. Results The costs per 100 treated U5 children were US$591.20 and US$298.42 for the iCCM trained-drug seller and iCCM trained-CHW models, respectively, with 30 and 21 appropriately treated children in the iCCM trained-drug seller and iCCM trained-CHW models. When the drug seller arm (intervention) was compared to the CHW arm (control), an incremental effect of 9 per 100 appropriately treated U5 children was observed, as well as an incremental cost of US$292.78 per 100 appropriately treated children, resulting in an incremental cost-effectiveness ratio (ICER) of US$33.86 per appropriately treated U5 patient. Conclusion Since both models were cost-effective compared to the do-nothing option, the iCCM trained-drug seller model could complement the iCCM trained-CHW intervention as a strategy to increase access to quality treatment.

scholarly journals Cost-Effectiveness Analysis of Integrated Community Case Management Delivery Models Utilizing Drug Sellers and Community Health Workers for Treatment of Under-Five Febrile Cases of Malaria, Pneumonia, Diarrhea in Rural Uganda.

2021 ◽  
Author(s):  
Patrick Lubogo ◽  
John Edward Lukyamuzi ◽  
Deo Kyambadde ◽  
Alex Aboda Komakech ◽  
Freddy Eric Kitutu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Community Health ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Effectiveness Analysis ◽  
Delivery Models ◽  
Drug Sellers ◽  
Drug Seller

Abstract Background Malaria, pneumonia, and diarrhea continue to be the leading causes of death in children under the age of five in Uganda. To combat the above-mentioned febrile illnesses, integrated community case management (iCCM) delivery models utilizing CHWs or drug sellers have been implemented. The purpose of this study is to compare the cost-effectiveness of delivering iCCM interventions via drug sellers versus community health workers in rural Uganda.MethodologyThis study was a cost-effectiveness analysis to compare the iCCM delivery model utilizing drug sellers against the model using CHWs. The effect measure was the number of appropriately treated U5 children, and data on effectiveness came from a quasi-experimental study in Southwestern Uganda and the inSCALE cross-sectional household survey in eight districts of mid-Western Uganda. The iCCM interventions were costed using the micro-costing (ingredients) approach, with costs expressed in US dollars. Cost and effect data were linked together using a decision tree model and analyzed using the Amua modeling software.ResultsThe costs per 100 treated U5 were US$591.20 and US$298.42 for the iCCM trained-drug seller and iCCM trained-CHW models, respectively, with 30 and 21 appropriately treated children in the iCCM trained-drug seller and iCCM trained-CHW models. When the drug seller arm (intervention) was compared to the CHW arm (control), an incremental effect of 9 per 100 appropriately treated under-five children was observed, as well as an incremental cost of US$292.78 per 100 appropriately treated children, resulting in an ICER of US$33.86 per appropriately treated U5 patient.ConclusionSince both models were cost-effective compared to the do-nothing option, the iCCM trained-drug seller model could complement the iCCM trained-CHW intervention as a strategy to increase access to quality treatment.

scholarly journals Addressing child health inequity through case management of under-five malaria in Nigeria: A model-based extended cost-effectiveness analysis

2021 ◽  
Author(s):  
Rishav Raj Dasgupta ◽  
Wenhui Mao ◽  
Osondu Ogbuoji
Keyword(s):  
Cost Effectiveness ◽  
Child Health ◽  
Case Management ◽  
Indirect Costs ◽  
Cost Effectiveness Analysis ◽  
Medical Expenditure ◽  
Financing System ◽  
Treatment Coverage ◽  
Under Five ◽  
Effectiveness Analysis

AbstractBackgroundUnder-five malaria in Nigeria remains one of the biggest threats to global child health, accounting for 95,000 annual child deaths. Despite having the highest GDP in Africa, Nigeria’s current health financing system has not succeeded in reducing high out-of-pocket medical expenditure, which discourages care-seeking and use of effective antimalarials in the poorest households. Resultingly, Nigeria has some of the worst indicators of child health equity among low and middle-income countries, stressing the need to evaluate how the benefits of health interventions are distributed across socioeconomic lines.MethodsWe developed a decision tree model for case management of under-five malaria in Nigeria and conducted an extended cost-effectiveness analysis of subsidies covering the direct and indirect costs of treatment. We estimated the number of under-five malaria deaths averted, out-of-pocket (OOP) expenditure averted, cases of catastrophic health expenditure (CHE) averted, and cost of implementation.FindingFully subsidizing direct medical costs plus a voucher system to cover non-medical and indirect costs with pro-poor increase in treatment coverage would annually avert over 19,000 under-five deaths, US$205.2 million in OOP spending, and 8,600 cases of CHE. Per US$1 million invested, this corresponds to 76 under-five deaths averted, 34 cases of CHE averted, and over US$800,000 in OOP expenditure averted. Due to low current treatment coverage and high disease burden, the health and financial-risk protection benefits would be pro-poor, with the poorest 40% of Nigerians accounting for 72% of all deaths averted, 55% of all OOP expenditure averted, and 74% of all cases of CHE averted. Targeted subsidies to the poor would see significantly greater health and economic benefits per US$1 million invested than broad, non-targeted interventions.ConclusionSubsidizing case management of under-five malaria for the poorest and most vulnerable children would significantly reduce illness-related impoverishment and child mortality in Nigeria while preserving limited financial resources.

Sign in / Sign up

Export Citation Format

Share Document