Cost-effectiveness analysis of clinical specialist outreach as compared to referral system in Ethiopia: an economic evaluation.
Cost-effectiveness analysis of clinical specialist outreach as compared to referral system in Ethiopia: an economic evaluation.
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DOI：
10.1186/1478-7547-8-13
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发表时间：
2010-06-11
期刊：
影响因子：
--
通讯作者：
Nigatu, Tilahun H
中科院分区：
文献类型：
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作者：
Kifle, Yibeltal A;Nigatu, Tilahun H
背景：在缺乏专业卫生人力资源的国家，患者通常被转诊。另一种选择是动员专家，临床专家外展。本研究探讨临床专科推广是否是一种具有成本效益的方式，利用稀缺的卫生专业知识，提供专科护理相比，通过转诊系统提供这样的服务在Ethiopia.METHODS：一个横断面研究四个有目的地选择的区域医院和三个中央转诊医院进行了2009年2月4日至24日。分析的视角是社会性的，涵盖2007年4月1日至2008年12月31日的分析范围和时间框架。通过专家访谈、项目协调人、患者和记录审查收集数据。为确保评估的适当标准，获得了Jimma大学的伦理审查。结果：发现在125个专家日中，有532例患者在外展医院接受了手术。外科手术的单位费用为4，499.43埃塞俄比亚先令。另一方面，如果这125个临床专家日用于为从区医院和区域医院转往中央转诊医院的病人提供服务，则可为438名病人提供服务。通过转诊进行外科手术的单位费用为每名病人6，523.27 ETB。这使得临床专家推广1.45倍更具有成本效益的方式，利用稀缺的临床专家的时间相比，转诊system.CONCLUSION：临床专家推广是一个成本效益和节省成本的方式花费临床专家的时间相比，通过转诊系统提供类似的服务。
BACKGROUND: In countries with scarce specialized Human resource for health, patients are usually referred. The other alternative has been mobilizing specialists, clinical specialist outreach. This study examines whether clinical specialist outreach is a cost effective way of using scarce health expertise to provide specialist care as compared to provision of such services through referral system in Ethiopia.METHODS: A cross-sectional study on four purposively selected regional hospitals and three central referral hospitals was conducted from Feb 4-24, 2009. The perspective of analysis was societal covering analytic horizon and time frame from 1 April 2007 to 31 Dec 2008. Data were collected using interview of specialists, project focal persons, patients and review of records. To ensure the propriety standards of evaluation, Ethical clearance was obtained from Jimma University.RESULTS: It was found that 532 patients were operated at outreach hospitals in 125 specialist days. The unit cost of surgical procedures was found to be ETB 4,499.43. On the other hand, if the 125 clinical specialist days were spent to serve patients referred from zonal and regional hospitals at central referral hospitals, 438 patients could have been served. And the unit cost of surgical procedures through referral would have been ETB 6,523.27 per patient. This makes clinical specialist outreach 1.45 times more cost effective way of using scarce clinical specialists' time as compared to referral system.CONCLUSION: Clinical specialist outreach is a cost effective and cost saving way of spending clinical specialists' time as compared to provision of similar services through referral system.