Cost Analysis of Tuberculosis Diagnosis in Cambodia with and without Xpert® MTB/RIF for People Living with HIV/AIDS and People with Presumptive Multidrug-resistant Tuberculosis

Pallas, Sarah Wood; Courey, Marissa; Hy, Chhaily; Killam, W P; Warren, David E.; Moore, Brittany K.

doi:10.1007/s40258-018-0397-3

Cited by 9 publications

(10 citation statements)

References 27 publications

(16 reference statements)

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“…To assess validity of our unit cost estimates, we compared our results with previously published estimates of TB diagnostics and interventions. [16,[24][25][26][27] Focusing on cost per Xpert test, we find our estimates consistent and comparable to the existing evidence (between $12 and $42 per test) factoring operational settings, costing methods, consumables costs, and testing volumes. In comparing our cost per program yield estimates, we found one study that reported costs of program operation and yields of the CATA program that overleaped with our assessment period but reporting much lower cost estimate.…”

Section: Discussionsupporting

confidence: 82%

Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan

Мирзоева²,

Chry

et al. 2020

PLoS ONE

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OPEN ACCESS Citation: Jo Y, Mirzoeva F, Chry M, Qin ZZ, Codlin A, Bobokhojaev O, et al. (2020) Standardized framework for evaluating costs of active casefinding programs: An analysis of two programs in Cambodia and Tajikistan. PLoS ONE 15(1): e0228216. https://doi.org/10. ConclusionsResults from two contextually and programmatically different multi-component ACF programs demonstrate that our tool is fully capable of comprehensively and transparently evaluating and comparing costs of various ACF programs.

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Section: Discussionsupporting

confidence: 82%

Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan

Мирзоева²,

Chry

et al. 2020

PLoS ONE

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“…As health system costs were not included in the program costing, we used primary cost data on personnel and diagnostics collected in 2014 ( Table 1 and Supplementary Table S1 ) to estimate costs incurred at the health facilities [ 18 ]. The costs per test or procedure were computed based on the number of people with presumptive TB referred to the health facilities and the number of tests conducted.…”

Section: Methodsmentioning

confidence: 99%

“…The costs per test or procedure were computed based on the number of people with presumptive TB referred to the health facilities and the number of tests conducted. We also included the cost of treatment/community directly observed treatment, short course (C-DOTS) reported in 2014 [ 18 ]. TB treatment was initiated and managed by the public health facilities regardless of the mode of case-finding strategies.…”

Section: Methodsmentioning

confidence: 99%

Economic Evaluation of Community Tuberculosis Active Case-Finding Approaches in Cambodia: A Quasi-Experimental Study

Teo

Prem

Wang

et al. 2021

IJERPH

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This study aimed to estimate the costs and incremental cost-effectiveness of two community-based tuberculosis (TB) active case-finding (ACF) strategies in Cambodia. We also assessed the number needed to screen and test to find one TB case. Program and national TB notification data from a quasi-experimental study of a cohort of people with TB in 12 intervention operational districts (ODs) and 12 control ODs between November 2018 and December 2019 were analyzed. Two ACF interventions (ACF seed-and-recruit (ACF SAR) model and one-off roving (one-off) ACF) were implemented concurrently. The matched control sites included PCF only. We estimated costs using the program and published data in Cambodia. The primary outcome was disability-adjusted life years (DALY) averted over 14 months. We considered the gross domestic product per capita of Cambodia in 2018 as the cost-effectiveness threshold. ACF SAR needed to test 7.7 people with presumptive TB to identify one all-forms TB, while one-off ACF needed to test 22.4. The costs to diagnose one all-forms TB were USD 458 (ACF SAR) and USD 191 (one-off ACF). The incremental cost per DALY averted was USD 257 for ACF SAR and USD 204 for one-off ACF. Community-based ACF interventions that targeted key populations for TB in Cambodia were highly cost-effective.

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“…To date, there are no costing studies on CS available for Cambodia. A few studies assessed the cost of specific health care services or diseases (e.g., [10][11][12][13]). The latest published costing study assessed the unit costs of public health care services in several health centres and hospitals using a step down costing approach [13].…”

Section: Introductionmentioning

confidence: 99%

“…A few studies assessed the cost of specific health care services or diseases (e.g., [10][11][12][13]). The latest published costing study assessed the unit costs of public health care services in several health centres and hospitals using a step down costing approach [13]. While it showed that costing was feasible with this methodology, the study can only inform about the costs of certain units like outpatient visits or inpatient days at certain departments.…”

Section: Introductionmentioning

confidence: 99%

Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care

Glaeser

Jacobs

Appelt

et al. 2020

IJERPH

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Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospital in Cambodia in the year 2018. We performed a full and a marginal cost analysis, i.e., we developed a cost function and calculated the respective unit costs from the provider’s perspective. We distinguished fixed, step-fixed, and variable costs and followed an activity-based costing approach. The processes were determined by personal observation of CS-patients and all procedures; the resource consumption was calculated based on the existing accounting documentation, observations, and time-studies. Afterwards, we did a comparative analysis between the two hospitals and performed a sensitivity analysis, i.e., parameters were changed to cater for uncertainty. The public hospital performed 54 monthly CS with an average length of stay (ALOS) of 7.4 days, compared to 18 monthly CS with an ALOS of 3.4 days at the NGO hospital. Staff members at the NGO hospital invest more time per patient. The cost per CS at the current patient numbers is US$470.03 at the public and US$683.23 at the NGO hospital. However, the unit cost at the NGO hospital would be less than at the public hospital if the patient numbers were the same. The study provides detailed costing data to inform decisionmakers and can be seen as a steppingstone for further costing exercises.

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Cost Analysis of Tuberculosis Diagnosis in Cambodia with and without Xpert® MTB/RIF for People Living with HIV/AIDS and People with Presumptive Multidrug-resistant Tuberculosis

Cited by 9 publications

References 27 publications

Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan

Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan

Economic Evaluation of Community Tuberculosis Active Case-Finding Approaches in Cambodia: A Quasi-Experimental Study

Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care

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