Costs, effects and cost-effectiveness analysis of a mobile maternal health care service in West Kiang, The Gambia.
J. Fox-Rushby, and F. Foord. Health policy (Amsterdam, Netherlands), 35 (2):
123--43(March 1996)
Abstract
The costs, effects and cost-effectiveness of a new mobile maternal care service offered in The Gambia at a government-run health centre in Karantaba were compared with the usual pattern of maternal care offered (at Ngayen Sanjal). Routinely collected data were supplemented by research on time allocation of staff by activity, use of drugs, medical consumables and vehicles, out-of-pocket payments by patients and a range of effectiveness indicators. To account for a differential effect on hospital referrals, maternity care at the main referral hospital was assessed. In 1991, the annual total cost of maternity care at Karantaba was US\$64 800 compared with US\$25 300 at Ngayen Sanjal. The largest proportion of this difference was attributed to training. Whilst average cost/attendance was higher at Karantaba, the marginal cost of expanding the service to other villages was lower than the marginal cost at Ngayen Sanjal. Incremental cost-effectiveness of the mobile service at Karantaba was calculated according to best and worst case scenarios which showed that the extra cost/extra death averted per year ranged between US\$459 and US\$2134. Using discounted life years gained reduced the figures to US\$42.9 and US\$206.3. Various suggestions are offered for reducing the cost of the new service, and a number of methodological points are raised for discussion.
:Users/Miguel/Dropbox/Escola/Artigos/Fox-Rushby, Foord\_1996\_Costs, effects and cost-effectiveness analysis of a mobile maternal health care service in West Kiang, The Gambia.pdf:pdf
%0 Journal Article
%1 Fox-Rushby1996
%A Fox-Rushby, J a
%A Foord, F
%D 1996
%J Health policy (Amsterdam, Netherlands)
%K (Health),Community Administration,Rural Analysis,Financing, Area Care Catchment Centers,Community Centers: Costs,Health Costs: Health Life Motion Personal,Gambia,Gambia: Research,Health Research: Services Services,Maternal Services,Rural Services: Studies,Value Units,Mobile Units: \& and data,Health economics,Community economics,Maternal economics,Mobile economics,Rural epidemiology,Health methods,Maternal numerical of standards,Community standards,Maternal standards,Mobile standards,Rural statistics utilization,Cost-Benefit utilization,Mobile utilization,Public utilization,Time
%N 2
%P 123--43
%T Costs, effects and cost-effectiveness analysis of a mobile maternal health care service in West Kiang, The Gambia.
%U http://www.ncbi.nlm.nih.gov/pubmed/10156650
%V 35
%X The costs, effects and cost-effectiveness of a new mobile maternal care service offered in The Gambia at a government-run health centre in Karantaba were compared with the usual pattern of maternal care offered (at Ngayen Sanjal). Routinely collected data were supplemented by research on time allocation of staff by activity, use of drugs, medical consumables and vehicles, out-of-pocket payments by patients and a range of effectiveness indicators. To account for a differential effect on hospital referrals, maternity care at the main referral hospital was assessed. In 1991, the annual total cost of maternity care at Karantaba was US\$64 800 compared with US\$25 300 at Ngayen Sanjal. The largest proportion of this difference was attributed to training. Whilst average cost/attendance was higher at Karantaba, the marginal cost of expanding the service to other villages was lower than the marginal cost at Ngayen Sanjal. Incremental cost-effectiveness of the mobile service at Karantaba was calculated according to best and worst case scenarios which showed that the extra cost/extra death averted per year ranged between US\$459 and US\$2134. Using discounted life years gained reduced the figures to US\$42.9 and US\$206.3. Various suggestions are offered for reducing the cost of the new service, and a number of methodological points are raised for discussion.
@article{Fox-Rushby1996,
abstract = {The costs, effects and cost-effectiveness of a new mobile maternal care service offered in The Gambia at a government-run health centre in Karantaba were compared with the usual pattern of maternal care offered (at Ngayen Sanjal). Routinely collected data were supplemented by research on time allocation of staff by activity, use of drugs, medical consumables and vehicles, out-of-pocket payments by patients and a range of effectiveness indicators. To account for a differential effect on hospital referrals, maternity care at the main referral hospital was assessed. In 1991, the annual total cost of maternity care at Karantaba was US\$64 800 compared with US\$25 300 at Ngayen Sanjal. The largest proportion of this difference was attributed to training. Whilst average cost/attendance was higher at Karantaba, the marginal cost of expanding the service to other villages was lower than the marginal cost at Ngayen Sanjal. Incremental cost-effectiveness of the mobile service at Karantaba was calculated according to best and worst case scenarios which showed that the extra cost/extra death averted per year ranged between US\$459 and US\$2134. Using discounted life years gained reduced the figures to US\$42.9 and US\$206.3. Various suggestions are offered for reducing the cost of the new service, and a number of methodological points are raised for discussion.},
added-at = {2012-02-27T06:11:36.000+0100},
author = {Fox-Rushby, J a and Foord, F},
biburl = {https://www.bibsonomy.org/bibtex/2f2e5ab20e2c9aceea1c5d1e35f53802e/kamil205},
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issn = {0168-8510},
journal = {Health policy (Amsterdam, Netherlands)},
keywords = {(Health),Community Administration,Rural Analysis,Financing, Area Care Catchment Centers,Community Centers: Costs,Health Costs: Health Life Motion Personal,Gambia,Gambia: Research,Health Research: Services Services,Maternal Services,Rural Services: Studies,Value Units,Mobile Units: \& and data,Health economics,Community economics,Maternal economics,Mobile economics,Rural epidemiology,Health methods,Maternal numerical of standards,Community standards,Maternal standards,Mobile standards,Rural statistics utilization,Cost-Benefit utilization,Mobile utilization,Public utilization,Time},
month = mar,
number = 2,
pages = {123--43},
pmid = {10156650},
timestamp = {2012-02-27T06:11:47.000+0100},
title = {{Costs, effects and cost-effectiveness analysis of a mobile maternal health care service in West Kiang, The Gambia.}},
url = {http://www.ncbi.nlm.nih.gov/pubmed/10156650},
volume = 35,
year = 1996
}