HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.
HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.
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DOI：
10.1186/1472-6963-7-108
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发表时间：
2007-07-12
影响因子：
2.8
通讯作者：
Kahn JG
中科院分区：
文献类型：
--
作者：
Marseille E;Dandona L;Marshall N;Gaist P;Bautista-Arredondo S;Rollins B;Bertozzi SM;Coovadia J;Saba J;Lioznov D;Du Plessis JA;Krupitsky E;Stanley N;Over M;Peryshkina A;Kumar SG;Muyingo S;Pitter C;Lundberg M;Kahn JG
经济理论和有限的经验数据表明，随着小型项目的扩大，单位艾滋病毒预防项目产出的成本（单位成本）最初会下降。如果扩张继续超过经济上最优的规模，单位成本可能会达到最低点，并开始上升。关于规模和单位成本之间关系的信息对于预测全球艾滋病毒预防工作的成本和有效分配预防资源至关重要。“预防艾滋病：成本效益分析网络”（PANCEA）项目收集了5个国家6种类型的206个艾滋病预防项目2003年和2004年的成本和产出数据。对每个国家的每种干预类型的规模和效率之间的关系进行了检查。我们的团队通过将双变量回归线拟合到产出水平和单位成本的散点图中，表征了这种关联的方向、形状和强度。我们选择具有最高解释力（R2）的回归形式。在所有国家和干预措施中，效率随着规模的扩大而提高。在规模和效率的范围、最佳拟合回归形式和回归斜率方面，这种关联在干预措施和国家内部有所不同。用尺度来解释效率变化的比例在26% - 96%之间。规模翻倍导致单位成本平均降低34.2%（从2.4%到58.0%不等）。印度的两种回归趋势表明存在一个拐点，超过这个拐点，单位成本就会增加。单位成本随着服务类型和数量的扩大而降低。这些针对国家和具体干预措施的调查结果可以为预测扩大艾滋病毒预防工作的全球成本提供信息。
Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently. The "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project collected 2003 and 2004 cost and output data from 206 HIV prevention programs of six types in five countries. The association between scale and efficiency for each intervention type was examined for each country. Our team characterized the direction, shape, and strength of this association by fitting bivariate regression lines to scatter plots of output levels and unit costs. We chose the regression forms with the highest explanatory power (R2). Efficiency increased with scale, across all countries and interventions. This association varied within intervention and within country, in terms of the range in scale and efficiency, the best fitting regression form, and the slope of the regression. The fraction of variation in efficiency explained by scale ranged from 26% – 96%. Doubling in scale resulted in reductions in unit costs averaging 34.2% (ranging from 2.4% to 58.0%). Two regression trends, in India, suggested an inflection point beyond which unit costs increased. Unit costs decrease with scale across a wide range of service types and volumes. These country and intervention-specific findings can inform projections of the global cost of scaling up HIV prevention efforts.
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影响因子：
2.1
作者：
Johns, B;Baltussen, R
通讯作者：
Baltussen, R
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168.9
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Marseille, E;Kahn, JG;Jackson, JB
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OVER, M
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