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
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DOI：
10.1371/journal.pone.0228216
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发表时间：
2020-01-27
期刊：
影响因子：
3.7
通讯作者：
Sohn, Hojoon
中科院分区：
文献类型：
--
作者：
Jo, Youngji;Mirzoeva, Farangiz;Sohn, Hojoon
多年来，技术和流程创新使主动病例发现(ACF)计划能够扩大其容量和范围，以填补全球失踪结核病患者的差距。然而，随着ACF项目操作复杂性的增加和对大量资源承诺的需求，需要一种全面、透明和标准化的方法来评估ACF项目的成本，以正确确定ACF项目的成本和价值。方法基于对项目活动和财务报告的审查，对部署在柬埔寨和塔吉克斯坦的两个结核病REACH资助的ACF项目的项目经理进行多次访谈，我们首先确定了共同的项目组成部分，这构成了成本数据收集、分析和报告框架的基础。在每个方案构成部分和子活动组内，按相关资源类型(人力资源、资本、经常性和间接费用)收集和组织成本数据。分摊费用、间接费用和管理费用总额根据人力资源的直接贡献(例如，工作人员的数量及其对每个计划组成部分的相对工作量)分摊到每个活动类别中。资本资产针对计划组成部分进行了评估，并根据其预期使用年限和3%的贴现率进行了年化。结果在两个项目年(2013年4月至2015年12月)，柬埔寨和塔吉克斯坦ACF项目累计成本为336,951美元和771,429美元，用于筛查68,846和1,980,516目标人群，细菌学检测4,589和19,764名推定结核病患者，诊断731名和2,246名结核病患者。经常性成本是各自项目总成本的最大组成部分(54%和34%)，Xpert MTB/RIF(Xpert)测试为这两个项目产生了最大的项目组成部分/活动成本。在柬埔寨和塔吉克斯坦，每次筛查的成本分别为0.63美元和0.10美元，Xpert测试的成本分别为25美元和18美元；每个检测到的结核病病例(Xpert)的成本分别为373美元和343美元。结论来自两个上下文和程序上不同的多组件ACF项目的结果表明，我们的工具完全能够全面和透明地评估和比较各种ACF项目的成本。
IntroductionOver the years, technological and process innovations enabled active case finding (ACF) programs to expand their capacities and scope to have evolved to close gaps in missing TB patients globally. However, with increased ACF program's operational complexity and a need for significant resource commitments, a comprehensive, transparent, and standardized approach in evaluating costs of ACF programs is needed to properly determine costs and value of ACF programs.MethodsBased on reviews of program activity and financial reports, multiple interviews with program managers of two TB REACH funded ACF programs deployed in Cambodia and Tajikistan, we first identified common program components, which formed the basis of the cost data collection, analysis, reporting framework. Within each program component and sub-activity group, cost data were collected and organized by relevant resource types (human resource, capital, recurrent, and overhead costs). Total shared, indirect and overhead costs were apportioned into each activity category based on direct human resource contribution (e.g. a number of staff and their relative level of effort dedicated to each program component). Capital assets were assessed specific to program components and were annualized based on their expected useful life and a 3% discount rate. All costs were assessed based on the service provider perspective and expressed in 2015 USD.ResultsOver the two program years (April 2013 to December 2015), the Cambodia and Tajikistan ACF programs cumulated a total cost of $336,951 and $771,429 to screen 68,846 and 1,980,516 target population, bacteriologically test 4,589 and 19,764 presumptive TB, diagnose 731 and 2,246 TB patients in the respective programs. Recurrent costs were the largest cost components (54% and 34%) of the total costs for the respective programs and Xpert MTB/RIF (Xpert) testing incurred largest program component/activity cost for both programs. Cost per screening was $0.63 and $0.10 and cost per Xpert test was $25 and $18; Cost per TB case detected (Xpert) was $373 and $343 in Cambodia and Tajikistan.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.