Costs of TB services in India (No 1).
Costs of TB services in India (No 1).
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DOI：
10.5588/ijtld.21.0105
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发表时间：
2021-12-01
期刊：
影响因子：
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通讯作者：
Baena IG
中科院分区：
文献类型：
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作者：
Chatterjee S;Toshniwal MN;Bhide P;Sachdeva KS;Rao R;Laurence YV;Kitson N;Cunnama L;Vassall A;Sweeney S;Baena IG
印度缺乏支持增加结核病投资所需的经济分析。本研究从卫生系统的角度估计结核病服务的成本，以促进印度国家结核病消除规划的资源有效分配。根据全球卫生成本联盟标准，并使用价值结核病数据收集工具，从印度两个有目的选择的邦提供结核病服务的20个设施的多阶段分层随机样本中收集数据。单位成本使用自上而下（TD）和自下而上（BU）方法估算，并以2018年美元报告。提供50种结核病服务和4种干预措施的成本因成本计算方法而异。主要服务包括痰涂片显微镜检查、Xpert® MTB/RIF和X光，平均BU成本分别为2.45美元、17.36美元和2.85美元。卡介苗接种、被动病例发现、使用异烟肼预防5岁以下儿童结核病以及新发肺结核和肺外结核病例的一线药物治疗的平均BU成本分别为0.76美元、1.62美元、2.41美元、103美元和98美元。随着印度对诊断算法的审查以及结核病预防或治疗的扩大或更新，结核病服务和产出的单位成本现已可用于支持投资决策。
There is a dearth of economic analysis required to support increased investment in TB in India. This study estimates the costs of TB services from a health systems’ perspective to facilitate the efficient allocation of resources by India’s National Tuberculosis Elimination Programme. Data were collected from a multi-stage, stratified random sample of 20 facilities delivering TB services in two purposively selected states in India as per Global Health Cost Consortium standards and using Value TB Data Collection Tool. Unit costs were estimated using the top-down (TD) and bottom-up (BU) methodology and are reported in 2018 US dollars. Cost of delivering 50 types of TB services and four interventions varied according to costing method. Key services included sputum smear microscopy, Xpert® MTB/RIF and X-ray with an average BU costs of respectively US$2.45, US$17.36 and US$2.85. Average BU cost for bacille Calmette-Guérin vaccination, passive case-finding, TB prevention in children under 5 years using isoniazid and first-line drug treatment in new pulmonary and extrapulmonary TB cases was respectively US$0.76, US$1.62, US$2.41, US$103 and US$98. The unit cost of TB services and outputs are now available to support investment decisions, as diagnosis algorithms are reviewed and prevention or treatment for TB are expanded or updated in India.