Correction to: A Systematic Review of Methodological Variation in Healthcare Provider Perspective Tuberculosis Costing Papers Conducted in Low- and Middle-Income Settings, Using An Intervention-Standardised Unit Cost Typology

Cunnama, Lucy; Gomez, Gabriela B.; Siapka, Mariana; Herzel, Ben; Hill, Jennifer G.; Kairu, Angela; Levin, Carol; Okello, Dickson; Plosky, Willyanne DeCormier; Baena, Ines Garcia; Sweeney, Sedona; Vassall, Anna; Sinanovic, Edina

doi:10.1007/s40273-020-00928-0

Cited by 2 publications

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“…We applied the WHO costing guidelines for tuberculosis interventions in this study [ 11 ]. A micro-costing approach was applied to estimate the cost-effectiveness of MDR-TB treatment at TIC and TFC from the healthcare provider's perspective.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of treating multidrug-resistant tuberculosis in treatment initiative centers and treatment follow-up centers in Ethiopia

et al. 2020

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Background In Ethiopia, MDR-TB has become a significant public health threat; therefore, the Ministry of Health introduced two treatment approaches for MDR-TB cases: treatment initiative center (TIC) and treatment follow-up center (TFC). TIC is where patients usually are diagnosed and start the treatment. At TFC, we follow MDR-TB patients until they completed the treatment. However, there is no evidence about the cost-effectiveness of the approaches. Therefore, this study aimed to analyze the cost-effectiveness of MDR-TB treatment in TIC and TFC. Methods In this study, we employed a full economic evaluation from a providers' perspective. We followed a hypothetical cohort of individuals from the age of 15 for a lifetime using a Markov model with five mutually exclusive health states. We used both primary and secondary data sources for the study. Ingredient-based costing approach was used. The costs include healthcare provider costs (recurrent and capital cost) and patient-side costs (direct and indirect). We use a human capital approach to estimate the indirect cost. The cost estimates were reported in the 2017 United States Dollar (US$), and effectiveness was measured using disability-adjusted life-years (DALYs) averted. Both costs and health benefits were discounted using a 3% discount rate. Both average and incremental cost-effectiveness ratios (ICER) were reported calculated. One-way and probabilistic sensitivity analyses were reported to determine the robustness of the estimates.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of treating multidrug-resistant tuberculosis in treatment initiative centers and treatment follow-up centers in Ethiopia

et al. 2020

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“…We used an ingredient costing approach to estimate the provider costs of human resources, training and supporting the tuberculosis treatment adherence intervention in the sample of 15 of the 78 health facilities participating in the trial [9]. The time spent by health workers recorded on the time- and-motion studies, were valued using the staff grade and associated salaries of the tuberculosis focal person (one nurse) at each of the health facilities.…”

Section: Methodsmentioning

confidence: 99%

Effect of implementing digital adherence technologies on the use of health care providers’ time and the human resource cost of tuberculosis treatment adherence support in Ethiopia

Belachew,

Sahile,

Gadissa

et al. 2024

Preprint

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Background. The management of human resources for health is a key priority for resource constrained health systems. Digital adherence technologies (DATs) for treatment support offer an opportunity to reorganise existing healthcare worker workload. Historically, tuberculosis treatment services involved directly observed treatment with frequent patient visits to the clinic for treatment adherence support. More recently, digital technologies have offered an option for the digital monitoring of treatment adherence and remote support. The aim of this study was to determine how health care workers use their time following the implementation of digital adherence support, and the human resource cost of tuberculosis treatment adherence support. Methods. As part of the ASCENT three-arm cluster randomised trial of DATs for tuberculosis treatment support, we conducted time-and-motion studies in 15 of 78 ASCENT-trial health facilities for six-weeks. Healthcare workers recorded time spent on direct patient care and in-person adherence monitoring for 10 patients, as well as time spent on above-service activities. Total time use was calculated by multiplying time spent per visit by number of patient visits at the facility for six weeks and adding above-service time. In a facility-level analysis, we used negative binomial regression models to investigate associations between total time use and facility-level factors. Findings. HCWs spent 4% (126/2892) of time in minutes on in-person adherence monitoring in the Labels, compared to 7% (206/3126) in the Pillbox and 13% (587/4673) in the standard-of-care study arms. More time was spent on above-service activities in the standard-of-care (2360 minutes [SD:1951]) compared to the DAT arms (Pillbox: 2057min [SD:1570]; Labels: 2261min [SD:1360]). After adjusting for facility workload and number of people lost-to-follow-up, we did not find sufficient evidence of a difference in the human resource costs between the study arms (Labels IRR (95%CI): 0.71 (0.33; 1.52); Pillbox (95% CI) 0.71 (0.33; 1.52)). Conclusion. We found a small, although not statistically significant reduction, in human resource costs in the facilities where DATs were implemented. We observed changes in how healthcare workers spent their time, including a shift towards fewer health facility visits but more time spent on in-person adherence support. Further work is ongoing to assess the implications for the cost-effectiveness of the interventions.

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Correction to: A Systematic Review of Methodological Variation in Healthcare Provider Perspective Tuberculosis Costing Papers Conducted in Low- and Middle-Income Settings, Using An Intervention-Standardised Unit Cost Typology

Abstract: In the original version of this article, Fig. 3 was published in an incorrect format. The correct figure is published with this correction.

Cited by 2 publications

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Cost-effectiveness of treating multidrug-resistant tuberculosis in treatment initiative centers and treatment follow-up centers in Ethiopia

Cost-effectiveness of treating multidrug-resistant tuberculosis in treatment initiative centers and treatment follow-up centers in Ethiopia

Effect of implementing digital adherence technologies on the use of health care providers’ time and the human resource cost of tuberculosis treatment adherence support in Ethiopia

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